B1 Bodies — Training & Coaching Intake

Full Name

Date of Birth

Age

Pronouns

Gender

Email Address

Phone Number

Location / City

Occupation / Type of Work

Height

Weight

Emergency Contact Name

Emergency Contact Phone

PAR-Q Safety Check — please select one:

I have been cleared for all physical activity — no doctor restrictions My doctor has placed restrictions on my activity (please detail below)

Current or past injuries (body area, severity, when)

Any surgeries or significant medical procedures?

Any health conditions, chronic pain, or doctor's restrictions?

Medications that may affect exercise or energy levels?

Experience level

Complete beginner — never trained Some experience (under 1 year) Intermediate (1–3 years, fairly consistent) Advanced (3+ years, very consistent)

Days per week currently active

What does your current routine look like? (type, duration, intensity)

Types of training you currently do — tick all that apply

Main goals — tick all that apply

Describe your primary goal — what does success look like in 3–6 months?

What has held you back from reaching your goals in the past?

Any upcoming events, deadlines, or milestones driving this?

How would you rate your current nutrition?

Dietary preferences or restrictions — tick all that apply

Anything else about your eating habits we should know?

Are you currently using any supplements?

Average sleep per night

Stress level (1–10)

Daily water intake

How active is your daily life outside of exercise?

Mostly sedentary (desk job, lots of sitting) Lightly active (some walking throughout the day) Moderately active Very active (on feet most of the day)

Areas you are most interested in exploring — tick all that apply

Training format preference

Online coaching only In-person personal training only A mix of both — online & in-person Not sure yet — open to guidance

Equipment access — tick all that apply

Full commercial gym Home gym (weights & equipment) Minimal / dumbbells only No equipment — bodyweight only Outdoor spaces (parks, tracks, etc.) Not sure / varies

Preferred coaching style

Detailed explanations & education Direct instructions & structured plans A balanced mix of both Not sure yet — happy to be guided

How do you respond best to being coached?

Supportive & compassionate — encouragement and empathy keep me going Direct & firm — push me hard, hold me to my word, no excuses Just tell me what to do — I don't need motivation, I need a plan Honest above all — I want real feedback, even when it's uncomfortable Adaptable — read the room and adjust your approach as needed A mix — firm when I need it, supportive when things get tough

Preferred check-in frequency

Best time of day to train

Have you worked with a personal trainer or coach before? What worked — or didn't?

How did you find B1 Bodies?

Best way to contact you

Before we get into the details — tell me about you. Who are you? What does your day-to-day look like? What are you chasing, and why does it matter? How do you handle setbacks — do you bounce back fast, or do you need support to get back on track? What does your support system at home look like? Any random facts, life context, or things you think I should know before we start. The more I understand who you are — not just what you want to change — the better I can build something that actually fits your life.

Anything else you'd like to flag before we get started?

Progress photo consent

I consent to taking progress photos for personal tracking purposes I consent to photos/videos being used (anonymously) for coaching reference I do not consent to progress photos at this time

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Date