INTENT COACHINGTrain with purpose.Client intake & consultationThis form helps me understand your starting point, your goal, and how we can build a plan around your real life. Section 1 of 9 About youFull name *Email address (so we can reply) *Age / DOB *HeightCurrent weightGoal weightOccupationWorking dayMostly seatedMostly standingModerately activePhysically demandingShift work / irregular hoursAverage daily steps Your goalPrimary goalFat lossBuild muscleImprove strengthImprove fitnessBody recompositionHealth / lifestyleImprove confidenceOtherWhat would you most like to achieve over the next 12 weeks? *Is there a longer-term goal beyond the first 12 weeks?Why is achieving this important to you? Training historyCurrently exercising?YesNoGym experienceNeverBeginnerSome experienceExperiencedIf yes, what are you currently doing?Previous training typesResistance trainingRunningCyclingTeam sportsClassesFunctional / CrossFitOtherWhat training or exercises do you genuinely enjoy?Anything you dislike or would prefer not to do?Realistic training days per week2345+Approximate time available per session<45 min45–60 min60–75 min75+ minWhere will you train?Commercial gymHomeOutdoorsCombinationEquipment limitations Health & training readinessPlease answer honestly. This coaching intake does not replace medical screening, diagnosis or medical advice.Any current injury, pain or physical limitation that could affect exercise?YesNoDetails (if relevant)Any significant previous injuries or surgeries relevant to training?YesNoDetails (if relevant)Has a healthcare professional advised you to restrict or modify exercise?YesNoDetails (if relevant)Are you receiving treatment for an injury or condition affecting training?YesNoDetails (if relevant)Anything else about your health or exercise readiness your coach should know? NutritionCurrently track calories?YesNoApprox. kcal/dayCurrently track protein?YesNoApprox. g/dayTypical day’s eatingBreakfastLunchDinnerSnacksDrinksDietary requirements, allergies or intolerancesFoods you avoid or strongly dislikePrevious approachesCalorie trackingIntermittent fastingLow carbohydrateKetoVegetarian / veganNoneOtherHow would you describe your current nutrition?Very structuredGenerally goodInconsistentFrequently overeatPortion-size strugglesWeekends / socialBiggest nutritional challenge Lifestyle, recovery & cardioSleep / night (hours)Sleep quality /10Select rating1 / 102 / 103 / 104 / 105 / 106 / 107 / 108 / 109 / 1010 / 10Energy /10Select rating1 / 102 / 103 / 104 / 105 / 106 / 107 / 108 / 109 / 1010 / 10Stress /10Select rating1 / 102 / 103 / 104 / 105 / 106 / 107 / 108 / 109 / 1010 / 10Weekends vs weekdaysLess activeSimilarMore activeAlcoholNoneOccasionally1–2 days/week3+ days/weekCurrently performing cardio?YesNoCardio typeCardio sessions / weekCardio durationEnjoy cardio?YesSome formsNot particularlyPreferred cardio Women’s health & hormonal factors (optional)Optional — you may select “Prefer not to say” or leave this section blank.Are there menstrual-cycle or hormonal factors you feel may affect training, nutrition, energy or recovery?NoYesUnsurePrefer not to sayAnything you’d like your coach to be aware of? Your coachingWhat do you feel has stopped you achieving your goal previously?What usually causes you to fall off track?When things don’t go to planI get straight back into routineI struggle for a few daysI tend to give upIt variesWhat do you want most from your coach? (Tick all that apply)AccountabilityStructureMotivationEducationTraining guidanceNutrition guidanceChallenge meConsistencyPreferred coaching styleDirectSupportiveEducationalA mixture Your starting pointConfidence you can achieve your goal /10Select rating1 / 102 / 103 / 104 / 105 / 106 / 107 / 108 / 109 / 1010 / 10Motivation to make changes now /10Select rating1 / 102 / 103 / 104 / 105 / 106 / 107 / 108 / 109 / 1010 / 10Readiness to commit to the process /10Select rating1 / 102 / 103 / 104 / 105 / 106 / 107 / 108 / 109 / 1010 / 10What would make the next 12 weeks a success beyond simply seeing a number on the scales?WHY NOW? What has made this the right time for you to make a change? *There is no perfect starting point. The goal is to build a plan you can execute consistently and with purpose. I agree to INTENT Coaching using my answers to respond to my enquiry and assess coaching suitability. I understand this includes health information I choose to provide. Please see the website privacy notice for details. Website BackContinue →Submit consultation INTENT COACHING · TRAIN WITH PURPOSE · This consultation is not a substitute for medical screening or advice.