Fitness Intake | Falcons City SC

Personal Information

Full Name * Age *

Gender *

Male Female

Height * Current Weight * Phone Number * Zip Code * Email Address *

Main Fitness Goal

What is your main goal for the next 8-12 weeks? *

Current Activity Level

How many days do you exercise per week? *

0 days 1-2 days 3-4 days 5+ days

What type of exercise do you currently do? *

What is your job / activity type? *

Mostly sitting / sedentary Mixed sitting and moving Active / physically demanding

Lifestyle

Meals per day * Hours of sleep per night Water per day (liters) * Snack habits *

Do you take any supplements? *

Health & Safety

Any disease, medical condition, or health concern that may affect exercise or nutrition? * Any current injury, pain, or movement limitation? * Any medication that may affect exercise, appetite, hydration, or energy? * Any food allergies or food restrictions? *

Food Preferences

Select the foods you are willing to include. Do not select foods you dislike or do not want to eat.

Additional Notes

Any foods you want to add to your diet? * Any foods you want to avoid completely? * Any additional notes for the coach? *

Acknowledgment

I confirm that the information I provided is accurate to the best of my knowledge. I understand that Falcons City SC fitness and nutrition support is for coaching and lifestyle guidance only, and does not replace medical advice from a doctor or licensed healthcare provider. *

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