Fitness Intake — Falcons City SC

Section 1

Personal Information

Full Name * Age *

Gender *

Male Female

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

Section 2

Main Fitness Goal

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

Section 3

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

Section 4

Lifestyle

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

Do you take any supplements? *

Section 5

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? *

Section 6

Food Preferences

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

Section 7

Additional Notes

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

Section 8

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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