New Client Intake — The WELLness Collective

Step 1 of 5

Let's get to know you.

Basic info so Briana can personalize everything for you.

First Name *

Last Name *

Email *

Phone

Age *

Preferred Start Date

What are you interested in? *

How did you hear about The WELLness Collective?

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Step 2 of 5

Your goals.

What are you working toward? Be as specific as you'd like — this shapes everything.

What is your main goal? *

Check all that apply

In your own words — what do you want to achieve? *

This shapes everything about your program.

How do you want to feel at the end of your program?

What has held you back in the past?

No judgment here — this helps Briana build a program that works around real obstacles.

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Step 3 of 5

Your training.

Tell Briana about your fitness background so she can meet you exactly where you are.

How would you describe your current fitness level? *

Beginner — brand new

Some experience — on and off

Intermediate — 1–2 years

Advanced — 3+ years

How many days per week can you commit to training? *

2 days

3 days

4 days

5 days

Where will you be working out? *

Gym — full equipment

Home — dumbbells only

Home — resistance bands

Mix of gym + home

How long do you have for each workout?

30 min

45 min

60 min

75+ min

Do you have any injuries, limitations, or areas to avoid?

Any exercises you love or hate?

Totally optional — but helpful!

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Step 4 of 5

Your nutrition.

No food diary required — just a sense of where you're at so Briana can set realistic goals.

How would you describe your current eating habits?

Pretty healthy overall

Good some days, not others

Needs a lot of work

Not sure where to start

Do you track protein intake currently?

Yes — consistently

Sometimes

No — but I want to

No — not into tracking

Daily protein goal (if known)

Daily water goal (if known)

Daily step goal (if known)

Anything else about your nutrition Briana should know?

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Step 5 of 5

Your lifestyle.

Wellness is more than workouts. Help Briana understand the full picture.

How is your sleep? *

Great — 7–9 hrs consistently

Okay — hit or miss

Poor — under 6 hrs usually

Interrupted — kids, stress, etc

How would you rate your current stress level?

Very low Very high

How would you rate your current energy levels?

Very low Very high

How busy is your daily life?

Manageable — I have some time

Busy — kids, work, life

Very busy — barely breathing

Varies week to week

What does your support system look like?

Who's in your corner? This helps Briana understand your environment.

Is there anything else you'd like Briana to know?

I agree to show up for myself. *

Not perfectly — but consistently. That's all we ask.

Yes — I'm ready. Let's go.

New Client Intake Form

Let's get to know you.

Your goals.

Your training.

Your nutrition.

Your lifestyle.

You're all set, .