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CLIENT INTAKE FORM

By submitting this form, you are not obligated for any financial services provided by Traverse Fitness. This form is a pre-requisite to ensure that our initial consultation is as comprehensive as possible to ensure your questions/needs are met with the highest standards.

First name

Last name

Email

Phone

Birthday

Month

Day

Year

Primary Goals

Primary fitness goals? (muscle gain, fat loss, strength, recomposition, etc.)

Why are these goals important to you?

Do you have a specific timeline or event you’re working toward?

How will you define success from coaching?

Training History & Experience

How long have you been training consistently?

Describe your current training routine (days/week, style, duration):

Types of training you enjoy:

Types of training you dislike or avoid:

Have you worked with a coach before? What worked or didn’t work?

Injuries & Medical History

Current or past injuries (please explain):

Chronic pain, joint issues, or movement limitations:

Medical conditions your coach should be aware of:

Are you currently under physician care?

Are you cleared for exercise by a medical professional?

Yes

No

Hormonal & Health Considerations

Have you ever had testosterone or hormone levels tested?

Yes

No

Any history of low testosterone symptoms?

Yes

No

Not Sure

Current or past use of hormone replacement therapy (TRT/HRT):

Yes

No

Any cardiovascular, blood pressure, or metabolic conditions:

Nutrition & Diet History

Describe your current eating habits:

Do you track calories or macros?

Yes

No

Food allergies, intolerances, or dietary preferences:

Average daily water intake:

Biggest challenges with nutrition consistency:

Lifestyle, Stress & Recovery

Occupation & typical daily activity level:

Average hours of sleep per night:

7 - 8 hours

6 - 7 hours

5 - 6 hours

<5 hours

Sleep quality:

Excellent

Good

Fair

Poor

Current stress level (1-10):

Primary sources of stress:

Schedule & Training Logistics

How many days per week can you realistically train?

Preferred training time(s):

Training location:

Home

Gym

Bodyweight

Equipment available:

Mindset & Accountability

What typically causes you to fall off track?

What motivates you most?

Preferred accountability style:

What does a supportive coach look like to you?

Additional Information

Supplements currently used:

Medications currently taken:

Anything else I should know to better support you?

Client Agreement & Acknowledgment

By completing this form, you confirm that all information provided is accurate to the best of your knowledge, understanding that online fitness coaching is not a substitute for medical care and that you are responsible for communicating any changes in health status.

Signature

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Date

Month

Day

Year

Please submit the client intake form to better assist with our initial consultation. I will reach out within 24-48 hours after submission. Thanks for your patience!

btravfit@gmail.com

+1 (276) 971-7597

Saint Petersburg Florida

© 2025 TRAVERSE FITNESS. THE GOLD STANDARD IN PHYSIQUE TRANSFORMATION.

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