Movement Assessment
Intake Form

This mini-assessment helps us understand your body, lifestyle, and goals before you step into the gym.

Name

Birthday

Day

Month

Year

Address

Phone

What is your primary goal?

Eg: Eliminate Pain/Discomfort, Post-Rehab/Recovery, Structural Strength, Athletic

Do you currently experience pain or stiffness during daily movement?

Yes

Yes (Constant), Yes (Only during exercise), No (I just want to move better).

What is one thing you’d like to be able to do "pain-free" in 90 days?

Have you worked with a trainer or physiotherapist before?

Preferred contact method:

Select your Availability

September 2026

Week starting Sunday, September 20

Time zone: Coordinated Universal Time (UTC)Business location

Friday, Sep 25

10:00 AM - 11:00 AM

11:00 AM - 12:00 PM

12:00 PM - 1:00 PM

1:00 PM - 2:00 PM

Your information is kept confidential and used only to design your bespoke training plan.