New Client Intake | Strikeline Training Group

Contact Information

Full Name

Date of Birth

Gender

Male Female Prefer not to say

Home Address

City

Zip Code

Phone Number

Email

Emergency Contact Name

Emergency Phone

Relationship to Client

Sports

Lifestyle

Occupation

Work Activity

Standing Sitting Driving Active

Average Work Hours / Week

Smart Watch Brand

Training Frequency

Training Type

Preferred Training Time

Preferred Session Duration

Height

Weight

Age

Equipment Access

Injuries / Medical Issues

Medical Clearance Required

Yes No

Describe Your Eating Style

Comments

Training Goals

Run Time

Other Goals

Nutrition — Preferred Foods

Allergies or No-Go Foods

Re-Feed Meals / Favorite Foods

Accountability & Coaching

Are you currently first responder or military?

Yes No

Required Weight and Fitness Test Standards

Household Cooking or Portioning Challenges

When motivation drops or life gets in the way, how do you want to be coached?

Reschedule if unprepared Use session to identify friction points and adjust If recurring discuss or restructure priorities Pause program until goal alignment returns Troubleshoot and simplify plan Adjust goals to build momentum

Tell us wherethe system is leaking.

Contact Information

Lifestyle

Training Goals

Nutrition — Preferred Foods

Accountability & Coaching

Tell us where
the system is leaking.