Intake Forms — Mobyl

1 — Personal Information

Full Name *

Preferred Name

Date of Birth *

Phone *

Email *

Occupation

Address

Emergency Contact & Phone

2 — Health & Medical History

Other medical conditions or diagnoses

Current medications

Any injuries, pain, or physical limitations we should be aware of?

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

Yes No

If yes — please provide details

Note: If you answered Yes above, we may request a GP clearance letter before commencing your program. Your safety is our priority. Please consult your doctor if you are unsure about beginning an exercise program.

3 — Current Lifestyle & Activity

Current occupation

How would you describe your typical day?

Mostly sedentary Light movement Moderately active Very active

How many days per week do you currently exercise?

0 days 1–2 days 3–4 days 5+ days

What types of exercise do you currently do?

Walking / jogging Gym / weights Group fitness Sport / recreational Yoga / Pilates Cycling / swimming None at the moment

Average sleep per night

Less than 5 hrs 5–6 hrs 7–8 hrs More than 8 hrs

Current eating habits

Mostly whole foods Mixed / trying to improve Largely processed Specific diet

Dietary preferences or restrictions

Glasses of water per day

Less than 4 4–6 glasses 7–8 glasses 8+ glasses

4 — Body Composition & Goals

Current Weight (lbs)

Height (ft / in)

Pants Size (optional)

Primary goal

Lose body fat Build muscle / tone Improve general fitness Athletic performance

Secondary goals (select all that apply)

Improve energy Reduce pain / improve mobility Improve confidence Manage a health condition Improve posture Reduce stress Improve sleep

Specific target weight or body composition goal?

Timeframe for achieving your goal

4–6 weeks 3 months 6 months 12 months+

5 — Training Preferences & Availability

Sessions per week

1 session 2 sessions 3 sessions 4+ sessions

Preferred session time(s)

Early morning Morning (7–10am) Midday Afternoon / Evening

Preferred training environment

Gym / facility Outdoors Home-based No preference

Equipment access

Gym membership Home equipment Minimal equipment No equipment

Any exercises or activities you strongly dislike or wish to avoid?

6 — Mindset & Commitment

What has stopped you from achieving your goals in the past?

What does success look like to you in 3 months?

How did you hear about Mobyl?

Referral / friend Instagram / social media Google search Other

7 — Informed Consent & Waiver

I understand that personal training involves physical exercise and that there are inherent risks associated with participation. I confirm that the information I have provided is accurate and complete to the best of my knowledge. I agree to inform my trainer of any changes to my health or medical status. I understand that Mobyl trainers are not medical professionals and that advice provided does not replace medical advice. I consent to the collection and secure storage of my personal information for the purposes of program delivery.

Full Name (as signature) *

Date *

Client Intake Forms

Thank you!

Thank you!