Intake form

Name *

Email address *

What is your primary fitness goal?

Please select at least one option.

Increase strength

Improve endurance

Gain muscle mass

Lose weight

Enhance athletic performance

Improve flexibility

General fitness

What is your current fitness level?

What type of training have you done in the past?

Please select at least one option.

Weightlifting

Running

Cycling

Swimming

Team sports

Yoga

Pilates

How many days per week can you commit to training?

Do you have any injuries or medical conditions we should be aware of?

What equipment do you have access to?

Please select at least one option.

Dumbbells

Barbell

Resistance bands

Kettlebells

Gym machines

Bodyweight

None

What is your age?

What is your gender?

What is your location?

Which service or services are you interested in? *

Please select at least one option.

Online training packages

Additional questions or comments

Pichardo Performance