Health readiness
Answer these questions as accurately as possible. Your coach may ask for additional clearance before exercise if needed.
Has a medical provider advised you to avoid exercise?No Yes Not sure
Chest pain, dizziness, or fainting during activity?No Yes Not sure
Known heart, blood pressure, or circulation condition?No Yes Not sure
Diabetes, thyroid, metabolic, or hormone-related condition?No Yes Not sure
Current medications or supplements
Medical notes or restrictions
Injuries and movement
Share current or past injuries, pain, or movements that need to be modified.
Current pain or injury?No Yes Sometimes
Movement limitationsNone known Knee / lower body Shoulder / upper body Back / core Multiple areas Not sure
Describe injuries, pain, or limitations
Exercises or activities you need to avoid
Review and submit
Review your answers before sending them to your coach.
I confirm this information is accurate to the best of my knowledge and understand my coach may follow up for clarification.
After submission, your coach receives the completed intake record. If configured, a PDF copy is also emailed to the intake recipient.