ATHLETE INTAKE

Name

First Name

Last Name

Age

Pronouns

Sport/ Preferred Activity

Preferred Days/ Times

Weekday AM

Weekday Midday

Weekday PM

On a scale of 1-10, what is your current activity level

1 = couch surfing, 5 = active 2- 3x/week, 10 = I could run an ironman next week

Please describe your training background.

Past activities, methods of exercise, athletic background, working with a trainer, etc.

Please describe any past or current injuries that may affect your training.

What are your biggest obstacles when it comes to training?

Please list 2-3 process goals (short term goals that will allow you to see progress).

Please list 1-2 outcome goals (bigger goals that will take time to achieve).

What is your WHY? Why do you want to start this process?

List 3 words to describe yourself!