Client Intake Form — The Aesthetic Blueprint

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About You

Basic info so we can get started and stay in touch.

First Name *

Last Name

Email Address *

Instagram Handle

Optional — makes it easier for me to follow your progress and stay connected.

Age *

Location

Height

cm

Current Weight

kg

Occupation

Helps me understand your daily energy demands and schedule flexibility.

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Training Background

Tell me where you're at right now — no judgement, just honesty.

How long have you been training consistently? *

How many days per week can you train? *

3 days

4 days

5 days

6 days

What equipment do you have access to? *

Full commercial gym

Basic gym (limited machines)

Home gym (barbells/dumbbells)

Dumbbells / bands only

Roughly how long is each session?

45–60 min

60–75 min

75–90+ min

What does your current training look like?

Approximate working weights on key lifts

Best estimates are fine. Helps me gauge where to set your starting intensities.

Bench Press

kg

Squat / Leg Press

kg

Overhead Press

kg

Pull-ups / Rows

Any injuries or physical limitations? *

What muscle groups feel most underdeveloped right now?

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Nutrition

How you eat right now — not how you think you should eat.

How would you describe your current eating? *

No structure — eat whatever

Roughly healthy, no tracking

Track calories loosely

Strict tracking

Roughly how many meals do you eat per day?

1–2 meals

3 meals

4–5 meals

If you selected any restrictions above — list the specific foods you cannot eat

Be specific — this helps me build a nutrition plan that actually works for you without guesswork.

Foods you dislike or refuse to eat

Do you drink alcohol? If so, how often?

Never

Rarely

Weekends occasionally

Most weekends

What's your biggest nutrition struggle?

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Lifestyle & Recovery

Results are built outside the gym too. This section matters more than most people realise.

Average sleep per night

Less than 6hrs

6–7hrs

7–8hrs

8hrs+

How would you rate your daily stress levels?

Very low Moderate Very high

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What does your job demand physically?

Desk job / sedentary

On feet (retail / hospitality)

Physically active (trades)

Student / mixed

Do you do any cardio or activity outside of lifting?

What supplements are you currently taking?

How consistent have you been over the past 3 months?

Very inconsistent Moderate Very consistent

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What typically gets in the way of your training?

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Goals & Expectations

The more specific you are here, the better I can build around what actually matters to you.

WHAT is your number one Health & Fitness goal or main priority? *

Be as specific as possible. This is the north star everything gets built around.

Other reasons you're getting started — this is to / for?

The deeper the reason, the stronger the commitment. Don't hold back.

WHAT are you struggling with or has held you back the most on your fitness journey? *

What do you need the most assistance or guidance with? *

Building a structured training program

Nutrition & eating for my goal

Staying consistent & accountable

Progressive overload & programming

Technique & form on exercises

Recovery & avoiding burnout

Mindset & motivation

Understanding my body & composition

Primary goal right now *

Lean bulk — build muscle, stay lean

Cut — lose fat, retain muscle

Recomp — both at once

Improve aesthetics / proportions

What does your ideal physique look like?

Be specific. Reference someone if it helps — athlete, physique you've seen online, etc.

What's the #1 thing you want to fix most? *

Have you worked with a coach before?

No, first time

Yes — online coach

Yes — gym PT

Tried a few programs

If you've had coaching before — what didn't work?

How committed are you to this right now?

Just testing the water Pretty serious All in

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Is there anything else I should know?

ClientIntake Form

About You

Training Background

Nutrition

Lifestyle & Recovery

Goals & Expectations

You're in.

Client
Intake Form