New Client
Intake Form

Answer as honestly as possible. This form helps build a safe, effective plan. Write "N/A" if a question does not apply. All information is confidential.

01 Personal Information

First Name *

Last Name *

Email Address *

Phone Number

Date of Birth

City / State

Preferred Pronouns

Age

Weight (lbs or kg)

Height (ft/in or cm)

Sex Assigned at Birth

Male Female Non-binary Prefer not to say

02 Training Background

Training Frequency / Week

0–1x 2–3x 4–5x 6+x

Gym Access

Commercial gym Home gym

Preferred Equipment / Notes

03 Goals & Motivation

Goal Timeline

3 months 6 months 12 months Ongoing

Describe your #1 goal in your own words *

What has held you back from reaching this goal in the past?

04 Schedule & Availability

Preferred Training Time

Morning Midday Evening Late night

Desired Sessions / Week

3 days 4 days 5 days 6 days

Outside Activity

I walk regularly I ride a bike Both Neither

05 Medical & Injury History

Do you have any current injuries or pain?

Yes No Not sure

Do you have any chronic medical conditions (e.g. diabetes, hypertension)?

Yes No Not sure

Are you currently taking medications that affect training or nutrition?

Yes No Not sure

Have you had any surgeries in the past 2 years?

Yes No Not sure

Has a doctor ever told you NOT to exercise or only under medical supervision?

Yes No Not sure

If yes to any above — describe (injury, condition, medications, restrictions)

Movements or exercises you are UNABLE to perform

06 Nutrition & Lifestyle

Food Allergies or Strong Dislikes

Describe a typical day of eating (briefly)

07 Stress, Recovery & Lifestyle

Alcohol Consumption

Never Socially Regularly

Tobacco / Nicotine

Never Former Current

Occupation / Daily Activity Level

08 Mindset & Habits

Do you tend to oversleep?

Yes Sometimes No

Do you procrastinate?

Yes, often Sometimes Rarely

Do you experience depression or low mood?

Yes Sometimes No

Do you have difficulty following directions or staying on plan?

Yes Sometimes No

List habits you would like to change

09 Coaching Expectations

What do you expect from your coach?

How did you hear about Teleport Strength?

Your information is kept strictly confidential and used only for coaching purposes. By submitting you confirm the information above is accurate to the best of your knowledge.

✓ Your intake form has been received! A coach will be in touch within 1–2 business days to schedule your initial evaluation call.

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New ClientIntake Form

New Client
Intake Form