Teleport Strength — New Client Intake

01 Personal Information

First Name *

Last Name *

Email Address *

Phone Number

Date of Birth *

City / State

Preferred Pronouns

Sex Assigned at Birth

Male Female Non-binary Prefer not to say

02 Training Background

Training Experience *

< 1 year 1–2 years 3–5 years 5–10 years 10+ years

Primary Training Background (select all that apply)

Powerlifting Bodybuilding General Strength Athletic / Sport CrossFit / HIIT Other

Sessions Per Week

0–1x 2–3x 4–5x 6+x

Training Location

Home gym Commercial Garage Facility / Box

Equipment You Regularly Have Access To

03 Goals & Motivation

Primary Goal(s) — select all that apply

Build muscle Lose body fat Improve strength Athletic performance Body recomp General health

Goal Timeline

3 months 6 months 12 months Ongoing

Describe Your #1 Goal in Your Own Words *

What Has Held You Back Before?

04 Schedule & Availability

Preferred Training Time

Morning Midday Evening Late night

Desired Sessions / Week

3 days 4 days 5 days 6 days

05 Medical & Injury History

Answer honestly — this keeps your programming safe. If you're unsure, select "Not sure."

Do you have any current injuries or pain?

YES NO NOT SURE

Do you have any chronic medical conditions (e.g. diabetes, hypertension)?

YES NO NOT SURE

Are you currently taking medications that affect training or nutrition?

YES NO NOT SURE

Have you had any surgeries in the past 2 years?

YES NO NOT SURE

Has a doctor ever told you NOT to exercise, or to only exercise under medical supervision?

YES NO NOT SURE

If YES to any above — please describe

Movements or Exercises You Cannot Perform

06 Nutrition & Lifestyle

Dietary Approach

No restrictions Vegetarian Vegan Gluten-free Dairy-free Other

Daily Water

<2L 2–3L 3–4L 4L+

Avg. Sleep

<5h 5–6h 7–8h 8h+

Meals / Day

1–2 3–4 5+

Food Allergies or Strong Dislikes

Describe a Typical Day of Eating

07 Stress, Recovery & Lifestyle

Current Stress Level

Very low Low Moderate High Very high

Alcohol Use

Never Socially Regularly

Tobacco / Nicotine

Never Former Current

Occupation / Daily Activity Level

08 Coaching Expectations

What Do You Expect From Your Coach?

How Did You Hear About Teleport Strength?

Preferred Check-In Method

EverFit app Email Text Video call

09 Client Acknowledgment & Consent

I confirm that the information provided in this form is accurate to the best of my knowledge.

I understand that Teleport Strength coaching is not a substitute for medical care, diagnosis, or treatment.

I agree to notify my coach of any changes in my health, injuries, medications, or exercise restrictions.

Full Legal Name *

I have read and agree to the statements above. I understand this is an electronic acknowledgment.

Once submitted, Coach Lionel will receive your intake and reach out within 24–48 hours to schedule your evaluation call.

⚡

You're in the system.

Coach Lionel has received your intake form and will reach out within 24–48 hours to schedule your evaluation call.

Keep an eye on your email. Check your spam folder if you don't hear back.

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