Personal Training

New Client Intake Form

This covers your goals, training background, schedule, a standard health screening, and a short liability waiver. Please complete all sections before your first session — takes about 10 minutes.

Client Information

Section 1 of 8

Used so I can reply straight to you.
Goals & Focus

Section 2 of 8 — select all that apply.

Primary Goal(s)
Fat loss
Muscle growth
Glute growth / hourglass focus
Strength
General fitness / health
Posture / mobility
Event / photoshoot prep
Other (specify below)
Training Background

Section 3 of 8

Current Activity Level*
Sedentary
Lightly active (1-2x/week)
Moderately active (3-4x/week)
Very active (5+ x/week)
Equipment Access
Full commercial gym
Home gym (dumbbells / bands / limited kit)
Bodyweight only
Other (specify below)
Cardio Habits
Incline walk / treadmill
Cycling
Rowing machine
StairMaster
HIIT / intervals
None / prefer to avoid cardio
Schedule & Availability

Section 4 of 8

Preferred Time of Day
Morning
Afternoon
Evening
Flexible
Health & Injury Screening

Section 5 of 8 — a standard pre-exercise health screen (based on PAR-Q principles). Answer honestly — a "yes" doesn't mean you can't train, it may just mean adjustments are needed.

1. Has a doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor?
Yes
No
2. Do you feel pain in your chest during physical activity, or have you in the past month?
Yes
No
3. Have you lost your balance because of dizziness, or lost consciousness, in the past 12 months?
Yes
No
4. Do you have a bone, joint, or soft-tissue problem that could be made worse by exercise?
Yes
No
5. Is a doctor currently prescribing medication for blood pressure or a heart condition?
Yes
No
6. Are you currently pregnant, or within 6 months postpartum? (if not applicable, leave blank)
Yes
No
7. Do you know of any other reason you should not do physical activity right now?
Yes
No
Additional Health Details
If you answered yes to any question above or have a relevant medical condition, please consult your physician before beginning this program and share any relevant clearance or restrictions with HenchTechGuy.
Lifestyle & Recovery

Section 6 of 8

Current Stress Level*
Low
Moderate
High
Review Your Answers

Take a look before signing the waiver on the next step.

Liability Waiver & Release

Section 7 of 8 — please read carefully before signing. This waiver applies to all training sessions, programs, and advice provided by HenchTechGuy.

  • I confirm that the information provided in this intake form is accurate and complete to the best of my knowledge.
  • I understand that participation in physical exercise carries inherent risks, including but not limited to muscle strain, joint injury, and, in rare cases, more serious harm.
  • I confirm that I am physically fit to participate in a training program, or have disclosed any condition that may affect my ability to do so, and have sought medical clearance where advised.
  • I voluntarily assume all risks associated with training and release HenchTechGuy, its trainers, and affiliates from liability for any injury, loss, or damage arising from my participation, except where caused by gross negligence.
  • I agree to inform my trainer immediately of any pain, discomfort, or change in my health status during or between sessions.
  • I understand that results vary by individual and that no specific outcome is guaranteed.
Signature may be typed since this form is completed and returned digitally. Today's date is recorded automatically when you submit.
✓
You're all set

No need to do anything else — I'll take it from here.