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Comprehensive Client
Information form

Follow these five steps to complete your journey

Step 1

Let’s start with your name

Please fill in the details below so that we can get in contact with you about our program.



Instructions

This is your comprehensive client information sheet. Please provide some relevant personal information to allow us to best serve you. The answers to these questions are essential to allow us to design an optimized individual fitness program for you. Please answer all questions in the most accurate manner possible while being as concise as possible.

Disclaimer

Please recognize the fact that it is your responsibility to work directly with your physician before, during, and after seeking fitness consultation. As such, any information provided is not to be followed without the prior approval of your physician. If you choose to use this information without the prior consent of your physician, you are agreeing to accept full responsibility for your decision.

Step 2

What best describes you?

Please fill in the details below so that we can get in contact with you about our program.

(measures mm)
(measures in/cm)

(rank these goals according to importance with 1 being the most important and 8 being the least)

Step 3

What exercises you do?

Please fill in the details below so that we can get in contact with you about our program.

(check the box with your ability)

Exercises Advanced Intermediate Novice Unfamiliar
Compound movements
Barbell squats
Barbell deadlift
Barbell bench press
Bent-over barbell row
Barbell Shoulder Press
Pull-up
Barbell hack squat
Olympic movements
Snatch
Clean
(at least 3x per week)

Type of exercises:

  • Resistance Training (RT)
  • Interval Cardio Bouts (ICB)
  • Sport-Specific Work (SSW)
  • Low-intensity Cardio Bouts (LICB)

Duration:

  • In Minutes
(at least 3x per week)
Step 4

What lifestyle do you follow?

Please fill in the details below so that we can get in contact with you about our program.

(list the condition’s)
(please list them)
(please list them)

(provide amounts from your last two grocery bills)

(number per week)
(per week)
(per month)
(please list them below)

(i.e., which cause excessive gas, bloating, stuffiness, or congestion)

(as well as the doses you’re taking)

(If your answer is less than one month, please fill out your record according to your prior intake before this recent month.)

Step 5

Describe your miscellaneous Info?

Please fill in the details below so that we can get in contact with you about our program.

(please share it with us below)