Client Intake — Strong and Covered

Strong & Covered

Online Personal Training & Nutrition

New client intake form

Fill this in so your coach can build a program around you — takes about 5 minutes.

Step 1 of 7 Personal info

Personal information

First name *

Last name *

Email *

Phone

Age *

Height

Weight

Gender identity

Female Male Non-binary Prefer not to say

Occupation

Timezone / location

Health & medical

Any current or past injuries? *

Medical conditions (tick all that apply)

Hypertension (high blood pressure) Type 1 or Type 2 diabetes Heart condition or chest pain Asthma or breathing difficulties Thyroid condition PCOS or hormonal condition Osteoporosis or joint issues None of the above

Are you currently pregnant or postpartum?

No Currently pregnant Postpartum (within 12 months) N/A

Medications (if relevant to exercise)

Have you been cleared by a doctor to exercise?

Yes No — I need to check first No known issues, haven't asked

Fitness background

Training experience *

Complete beginner Some experience (6–12 months) Intermediate (1–3 years) Advanced (3+ years)

What type of training have you done before?

Weight training Cardio / running CrossFit / HIIT Yoga / Pilates Sports / martial arts Bodyweight / calisthenics None

Current strength levels (leave blank if unsure)

Squat

Bench press

Deadlift

Overhead press

Pull-ups

Cardio baseline

How would you rate your current fitness?

1 — Very unfit 2 — Below average 3 — Average 4 — Above average 5 — Very fit

How would you describe your mobility / flexibility?

Very stiff / restricted Somewhat tight Average Flexible

Goals & training preferences

Primary goal *

Fat loss / tone up Build muscle / bulk Increase strength Improve endurance / cardio Improve overall health Post-injury rehab Sport-specific performance Postpartum recovery

Describe your goal — what does success look like to you?

Your target timeline

4–6 weeks 3 months 6 months 12 months Long-term lifestyle change

What training style do you enjoy most?

Heavy lifting / powerlifting Hypertrophy (bodybuilding style) Circuit / HIIT Steady cardio Functional / athletic Low-impact / gentle No preference — coach decides

Exercises to avoid

Favourite exercises / muscle groups

Days available to train

Session length preference

Equipment access

Commercial gym Home gym (full setup) Dumbbells / basic equipment Resistance bands only Bodyweight only

Nutrition & diet

Diet / food restrictions

No restrictions Halal Vegetarian Vegan Kosher Keto / low-carb Paleo Gluten-free

Food allergies or intolerances

Walk me through a typical day of eating

Meals per day

Daily water intake

Do you track calories or macros?

Yes, consistently Sometimes No — never tried I'd like to start

Do you take any supplements?

Protein powder Creatine Pre-workout Vitamins / minerals Omega-3 / fish oil None

How would you describe your relationship with food?

Very healthy — no issues Some emotional eating I struggle with consistency History of disordered eating

This helps your coach tailor their approach — all answers are confidential.

Do you drink alcohol?

Do you smoke / use nicotine?

Lifestyle & schedule

Activity level outside the gym

Average nightly sleep

Daily stress level

How motivated are you right now?

Preferred days to train

Mon Tue Wed Thu Fri Sat Sun

Preferred time of day to train

Early morning (5–8am) Morning (8–11am) Midday (11am–2pm) Afternoon (2–5pm) Evening (5–8pm) Late night (8pm+)

How do you prefer to receive check-ins / feedback?

WhatsApp Email Video calls

What obstacles have stopped you reaching your goals before?

Anything else you want your coach to know?

Consent & agreement

By submitting this form, I confirm all information is accurate to the best of my knowledge. I understand that training and nutrition guidance is for general fitness and wellness purposes and does not replace professional medical advice. I agree to promptly communicate any changes in my health status, and I accept that individual results will vary based on effort, consistency, and adherence.

I have read and agree to the terms above I am 18+ years old, or have parental / guardian consent I consent to my information being used to build my personalised program I confirm I have no undisclosed medical conditions that could affect my safety

A note on safety

Your safety is our priority. Please be aware that exercise and changes to your diet carry a degree of personal responsibility — it's important to listen to your body and let your coach know if anything doesn't feel right at any point.

Strong and Covered provides guidance in good faith based on the information you share. We are not medical professionals, so the advice given is not a substitute for medical advice. If you have any health concerns, please check in with your doctor before getting started.

By continuing, you confirm that you are taking part of your own free will and that you'll keep your coach informed of any changes to your health or circumstances.

I understand that Strong and Covered is not a medical service and I will seek professional advice if needed I will inform my coach of any changes to my health and take responsibility for listening to my body

You're all set!

Your intake form has been received. Your coach will review everything and reach out within 24–48 hours to get your program started.