Workout Plan Intake Form | Viking Wellness Solu

First name

Last name

Age

Email

Phone:

Sex assigned at birth

Male

Female

Prefer Not to Say

We’re an inclusive community. Sex assigned at birth and hormone use can affect recovery, strength, and programming. If you’re transitioning or using hormone therapy, please share relevant details In blocks referencing that below or in the box "Anything else your coach should know?" so we can program appropriately.

Height (in inches)

Weight (in pounds)

If you checked any of the boxes above, please include all details.

Describe what your current training regimen is like (Days per week, exercises performed, etc.).

Training Experience

Where do you primarilay train?

*If you train at a home gym, please list ALL equipment you have available to workout with.

Do you want cardio programmed?

If yes, please give your coach your current cardio routine/capacity and what cardio equipment you have access to.

Realistically, how long can you train per session?

Injuries, pain, or limitations

Please be as detailed as possible any injuries, pain, or limitations you have so your coach can build a plan effective for YOU.

Are you currently using hormone therapy or performance-altering hormones?

If yes, please specify type, dosing protocol, and duration of use.

Anything else your coach should know?

Please list any exercise preferences or dislikes, or anything else your coach should know about you before building a plan.

Before beginning any training program, I acknowledge that it is my responsibility to consult with a physician and ensure I am medically cleared for physical activity. I understand that Viking Wellness Solutions does not provide medical advice. If my physician places restrictions on my activity, I agree to provide documentation so my program can be adjusted accordingly. Program modifications related to documented medical restrictions will be provided at no cost for 90 days from delivery.