Ceefit — Client Intake Form

1 — Personal details

First name *

Last name *

Email *

Phone

Date of birth

Gender

Nationality

Height

Current weight

Location / Country

2 — Goals & targets

Primary goal *

Specific target *

The more specific the better — this drives your programme design.

Deadline or event

What does success look like for you?

What has stopped you achieving this before?

Motivation level right now (1 = low, 5 = very high)

3 — Training & experience

Training experience *

How many days per week can you train? *

Preferred session length

Where will you train? *

Exercises or activities you dislike or want to avoid

4 — Health & medical

⚠️ You've indicated a health concern. Your coach will review this before your programme starts.

Please describe any health concerns in detail

Are you currently taking any medication?

When did you last have a health check?

Overall current health rating (1 = poor, 5 = excellent)

Energy levels day to day (1 = very low, 5 = very high)

Average sleep per night

Stress levels (1 = very low, 5 = very high)

5 — Nutrition & lifestyle

How would you describe your current diet?

Foods you love and want kept in your plan

Foods you dislike or can't eat

Any food allergies?

How many meals do you typically eat per day?

Water intake per day

Alcohol consumption

Occupation / work type

How active are you outside of formal exercise?

6 — Mindset & anything else

How do you respond to hard training sessions?

How do you prefer to be coached?

Is there anything else you'd like Caroline to know?

How did you hear about Ceefit?

Declaration * I confirm that the information I have provided is accurate and complete. I understand that this information will be used to design a personalised fitness programme for me.

Client Intake Form

1 — Personal details

2 — Goals & targets

3 — Training & experience

4 — Health & medical

5 — Nutrition & lifestyle

6 — Mindset & anything else

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