Client Intake Form Template for Supplement Guidance

Use in FirstRep form

Personal Information

Gathering personal information helps tailor supplement recommendations to individual needs.

Aa Full Name *

Enter your full name

# Age *

Enter your age

Aa Email Address *

Enter your email address

Fitness Goals

Understanding your fitness goals helps in selecting the right supplements.

vv What are your primary fitness goals? *

Select your goals

v Current fitness level *

Select your fitness level

Current Supplement Use

Knowing what supplements you currently use can prevent unnecessary recommendations.

... List any supplements currently being taken

Enter the names of supplements

Y/N Do you have any allergies? *

Dietary Preferences

Dietary preferences can affect supplement choices, ensuring they align with your lifestyle.

v Do you follow any specific diet? *

Select your diet type

Aa Favorite protein source

Enter your favorite protein source

Health Concerns

Identifying health concerns is crucial for safe supplement recommendations.

... Do you have any chronic health conditions?

List any chronic health conditions

... Are you currently taking any medications?

List any medications

Budgeting for Supplements

Understanding your budget helps in recommending effective and affordable supplements.

# Monthly supplement budget *

Enter your monthly budget for supplements

Y/N Are you open to trying new supplements? *

Why Use This Template

Personalized Recommendations

Get tailored supplement advice based on your unique needs.

Avoid Waste

Make informed choices to prevent spending on unnecessary products.

How to Use

Fill out the form completely to ensure accurate recommendations.

Review your answers before submission for clarity.

Customization Tips

Tailor the fields based on specific client needs.
Add or remove sections as necessary for clarity.
Incorporate additional questions based on local regulations.

Build and send supplement guidance templates digitally with FirstRep. Free for up to 3 clients.

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Frequently Asked Questions

What if I don't know my fitness level?

It's okay! Choose the option that feels closest to your current activity level.

Are supplements safe?

Many are safe, but it's essential to know your health conditions and consult a professional.