WELCOME TO DIESEL DRIVEN FIT

NEW CLIENT INTAKE.

Thanks for choosing Diesel Driven Fit. This questionnaire gives your coach the information needed to build a program around your goals, schedule, equipment, and life on the road.

✓ Be honest and specific✓ Complete this before your first program✓ Your answers help personalize your plan

Don’t fill this out if you're human:

1. BASIC INFORMATION

Full name Email Phone number Age Height Current weight

2. YOUR GOALS

Primary goal What would you like to accomplish in the next 90 days? Target weight or other measurable goal

3. LIFE ON THE ROAD

Type of driving How many days per week are you typically on the road? How many days per week can you realistically train? Typical workout time

4. EQUIPMENT

What equipment do you normally have access to?

5. TRAINING BACKGROUND

How long have you exercised regularly? Exercises you enjoy Exercises you dislike or want to avoid

6. NUTRITION

How would you describe your current eating habits? How many meals do you typically eat each day? What foods do you typically have available while driving? Foods you don't eat or prefer to avoid

7. ACCOUNTABILITY

What usually makes it difficult to stay consistent? What type of accountability would help most?

8. PROGRESS

Waist measurement (optional) Chest measurement (optional) Arm measurement (optional) Thigh measurement (optional)

9. EXERCISE SAFETY

Do you have any current injuries, physical limitations, or medical conditions that could affect exercise? Has a healthcare professional advised you to limit or avoid physical activity? I understand Diesel Driven Fit provides fitness coaching and general nutrition guidance, not medical diagnosis or treatment. I will consult an appropriate healthcare professional about medical concerns or exercise restrictions.

10. YOUR WHY

Why are you ready to make a change now? What has stopped you from reaching your goals in the past? What would success look like 90 days from now? Anything else you'd like your coach to know?