Online Coaching Intake Form

There are more questions here than most fitness coaches, and that's for a reason: I want to personalize the plan to you 100% looking at as many variables as possible. If you have any prerequisite questions before filling this out, send me a message on IG at @timvanlew. Answer all of the following to the best of your ability. We can chat through anything you believe may need further explanation during our consultation visit (Schedule here: https://calendly.com/tmvanlew/30min). After I receive this form I will be able to begin crafting a personalized workout and meal program to get you started toward hitting your goals.

What is your full name?

Age

Sex

Male

Female

Height

Weight

Phone number

Occupation (to understand activity levels and schedule):

Primary Goal (Weight Loss, Muscle Gain, Maintenance, Recomposition, Athletic Performance, etc.):

Instagram handle (optional)

💪🏼 Fitness Background

How long have you been working out?

0-1 year

1-3 years

3+ years

How many days per week are you currently training with weights?

0-1

2-3

4-5

What muscle groups are you most trying to bring up?

Do you have any physical limitations/injuries?

🏋🏼‍♀️ Current Training Routine

Can leave the below blank if you do not have a current routine

Describe your current workout routine

How many days per week can you dedicate to working out?

What is your preferred training time? (Morning, Afternoon, Evening)

🍗 Nutrition & Diet

Are you currently following any specific diet? (e.g., Keto, Low Carb, High Protein, Vegan, etc.)

How many meals do you typically eat per day?

Do you track your caloric intake? Yes/No (If yes, please provide your daily caloric/macro intake)

Do you have any dietary restrictions or allergies?

Do you use any supplements? (e.g., Protein Powder, Creatine, Pre-workout, Multivitamins, etc.)

Do you use any anabolic substances?

😴 Lifestyle & Habits

How many hours of sleep do you get on average?

Less than 4

4-6

6-8