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New Client Intake

This comprehensive form allows us to build a training plan that honors your medical history, hormonal health, and personal goals. By sharing these details, we ensure your journey is safe, effective, and tailored to exactly where you are right now.

Takes approx. 10 mins

Personal Details

Date of Birth
Month
Day
Year
Preferred Training Format
In-person in Deerfield
My home
Hybrid

Health & Lifestyle Questionnaire

This information helps us design a program that respects your body's current state and history. Your privacy and safety are our top priorities.

Medical History & Medications

Fitness Goals & Expectations

Help me understand what you want to achieve. Your vision for the next 3 to 6 months starts here.

Coaching Agreement & Terms

Please review these terms carefully. This agreement ensures a safe, effective, and respectful environment for your transformation. By proceeding, you acknowledge your dedication to your health and the training process.

  • Commitment: You agree to follow the training program and maintain open communication regarding progress.
  • Cancellations: A 24-hour notice is required for any session cancellations to avoid being charged.
  • Safety: You must disclose any physical limitations or pain immediately. You understand participation involves some risk.
  • Communication: We value professional boundaries and respond to inquiries within 24 business hours.

Informed Consent

I agree to engage voluntarily in Rachel Smith Fitness's exercise program in order to attempt to improve my physical fitness. I understand that the activities are designed to place a gradually increasing workload on the cardiorespiratory and muscular systems to attempt to improve their function. The reaction of the cardiorespiratory and muscular systems to such activities cannot be predicted with complete accuracy. There is a risk of certain changes that might occur during or following the exercise.


I understand the purpose of the exercise program is to develop and maintain cardiorespiratory fitness, body composition, flexibility, and muscular strength and endurance. A specific exercise plan will be given to me, based upon my needs and interests and my doctors' recommendations. All exercise programs include warm up, exercise, and cool down.


I understand that I am responsible for monitoring my own condition throughout each exercise session and, should any unusual symptoms occur, I will cease my participation and inform Rachel Smith of the symptoms.


In signing this consent form, I affirm that I have read this form in its entirety and that I understand the nature of the exercise program. I also affirm that my questions regarding the exercise program have been answered to my satisfaction.


I agree to assume any and all risk of participating in an exercise program and further agree to hold free, harmless, and fully indemnified, Rachel Smith and Rachel Smith Fitness, from any and all claims, suits, expenses, losses, or related causes of action for damages, including but not limited to, such claims that may result from any injury or death, accidental or otherwise, during, or arising in any way from the exercise program.



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