New Client Intake

Intended only for clients who have scheduled a complimentary consultation.

Please answer as completely and honestly as you are comfortable. You will discuss factors that impact training during your complimentary consultation. If there is anything sensitive that you would prefer not to detail in this form, please indicate as needed that you would like to discuss those answers in person. Please note that your answers are completely confidential, secure and protected. Forms are delivered directly to Jen's private inbox and are reviewed by her only.

GENERAL

Name

Age

Pronouns

she/her

he/him

they/them

other

Sex

male

female

Occupation

Family

How physically demanding are your daily demands outside of formal exercise?

Average number of hours/day spent working? Please indicate how many (if any) are spent at a desk.

Training Experience and Goals

If you have worked with a personal trainer before? If so, please briefly describe that experience with what you liked, anything you disliked, and whether that relationship ended for reasons other than availability or location:

Previous sport / recreational / workout experience?

Any previous injuries or ailments that prevented activity for any period of time?

Any diagnosed conditions and/or prescriptions that impact how activity feels?

What is your primary training goal?

Why is the above goal important to you?

Opportunity to elaborate further and discover your motivation: why is the above explanation of the goal's importance to you also important to you?

Health Habits and Lifestyle

At the onset, I want to emphasize that my training focuses on seeing what the body can DO, not just how the body looks. I do not weigh or measure the body, and do not consider those changing numbers as a sole indicator of success. I do not write nutrition plans, but can give holistic dietary guidance in some instances within a limited scope of expertise. In my experience, there are so many factors other than inches lost or calories burned, or eating specific foods that contribute to overall health. With that out of the way, please let me know the following:

Are you currently following any kind of diet or nutrition plan?

Is there a medical basis for this diet, and/or are you doing so under the supervision of a Registered Dietician?

Do your eating habits change based on whether you were active on a given day or not?

Do your eating habits change with shifts in your schedule or work/life demands?

On average, how many hours of sleep do you get? Do you feel rested when you wake up?

How would you rate your average weekly stress levels?

Any existing stress management tools that work well for you?

Daily caffeine/alcohol/other substance use (no judgment and I’m not a narc, just know it’s important for me to know!):

Is there anything else about you that you think is important for me to know in building a strong training relationship?