New Client Assessment Form

The Basics

Rate your interest in each goal on a 1-10 scale

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Habits, Health, Lifestyle

Food and Nutrition

Note: if you select 'macro plan', you will not receive a meal plan from me unless you specifically request a sample plan to use as a starting point or reference

Lifting and Cardio

Competition-related questions (non-competitors, enter 'N/A')

Confidentiality, terms and agreements

Confidentiality of submitted materials and expectation of privacy

Coach will hold all of client’s private information in confidence.  This includes email correspondence, text messages, content of assessment forms, progress photos, progress videos, personal information, and accounts of phone conversations.  Digital content will be stored on the personal computer of coach (including external hard drive) and accessible via cellular phone of coach (when applicable).

Confidentiality of program contents

Client understands that program provided by coach is for their individual, personal use only.  Program contents are not to be shared with others.  Formatting of weekly program updates and assessment forms are not to be copied or disseminated in any way, or implemented for professional use (formally or informally) by client under any circumstances.

Media Sharing Policy

Client understands that coach is allowed to use and re-post materials publically posted by client on social media outlets for promotional use.  This includes but is not limited to Facebook, Twitter, Instagram, tumblr, and individual blogs.  This clause applies only to information and media that is posted willfully by client in a public forum and does not apply to progress photos sent to coach without explicitly obtained permission beforehand.

Billing, cancellation, refund policy

Client agrees to establish monthly billing when advised to by coach.  Billing is conducted via PayPal subscription and renews automatically on the same date of each month until cancelled by either party.  Cancellation (permanent) and suspension (temporary, requires re-activation) of billing can be handled by client via their PayPal recurring payments dashboard at PayPal.com.  Payment is for the one-month period beginning on the date of each draft, and is non-refundable once processed.  Billing can be terminated at-will by either client or coach.  When billing is terminated, services including check-in calls and program updates will continue until the end of the billing cycle is reached.

Waiver of Liability

Client understands that physical exercise programs include inherent risk and do not hold coach responsible for injuries sustained while training.  Client is advised to seek physician’s approval before beginning any exercise program.  Client also understands that coach is not a registered dietician, and all dietary advice is given as guidelines and recommendations.

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