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Coaching Intake Form

SECTION 1 — WHO YOU ARE

Full name:

What is your email address?

When is your birthday?

What is your phone number?

Where are you located?

SECTION 2 — YOUR TRAINING

How long have you been exercising/training consistently?

Less thank a year

1 to 3 years

3 to 5 years

5+ years

What is your primary training goal right now?

Compete in powerlifting

Get stronger with no meet plans

Body composition change

General fitness and health

Combination of the above

Other

Are you currently competing or planning to compete?

Yes, actively competing

Planning to compete in the next 12 months

No competition plans right now

What does your current training week look like?

What are your current best lifts, or where are you at right now(Athletes only)?

SECTION 3 — NUTRITION

Are you currently tracking your nutrition?

Yes, consistently

Sometimes

No, not at all

Are you willing to track macros as part of your coaching plan?

Yes, fully committed

Yes but I may need help getting started

I prefer a general approach without strict tracking

Any dietary restrictions, allergies, or medical conditions I should know about?

SECTION 4 — COMMITMENT

What has held you back from reaching your goals so far?

Have you worked with a coach before? If yes, what worked and what didn't?

What does success look like for you in the next 6 months?

Is there anything else you want me to know before we start?

Disclaimer

You're in.

Payment confirmed.

Welcome to the team.

Here's what happens next:

You'll hear from me within 24 hours at the email you providedI'll send you a link to download the app and set up your profileWe'll book your first check-in call or video within the first weekYour custom program will be live in the app before your first training day

Any questions before I reach out, DM me directly on Instagram @topcoachdino.

Let's get to work.