Client Intake

Welcome

IMPORTANT: Please send current progress photos (Front, Side, and Back Views) with the least amount of clothing possible.

Example:

  • Ladies – Sports Bra and Shorts
  • Men –Shorts only

Take photos first thing in the morning before food and water. Please do the same for every check in photos with current weight as well.

Please email your photos to macroscoach@gmail.com

To take photos, best way is to turn your camera/video on, on your phone. Tap the screen to flip it where it faces you. Set it on the counter or table and stand under good lighting. Video yourself standing in front you, then turn your body to the side then turn away from the video so you get a back shot. Then go back thru video and do a screen shot for the three shots.

Questionnaire

Years
Inches
Pounds
Do you do any cardio right now? *
Do you lift any weight right now? *
Days
Days
Any major surgeries in the past 12 months? *
Any knee, hip, or back problems? *
Are you currently taking any medication? *
Anything else we should know? *

Liability Disclaimer

In consideration of being allowed to participate in the personal fitness training activities and programs of Macros Coach, LLC, Dustin M. Rhoads and to the use of its facilities, equipment, and services, in addition to the payment of any fee or charge, I do hereby forever waive, release, and discharge, Macroscoach, LLC, Dustin M. Rhoads and its officers, agents, employees, representatives, executors, and all others acting on their behalf from any and all claims or liabilities for injuries or damages to my person and/or property, including those caused by the negligent act or omission of any of those mentioned or others acting on their behalf, arising out of or connected with my participation in any activities, programs, or services of Macros Coach, LLC, Dustin M. Rhoads, or the use of equipment at various sites, including home, provided by and/or recommended by Macros Coach, LLC, Dustin M. Rhoads.

I have been informed, understand and aware that strength, flexibility and aerobic exercises, including the use of equipment, are potentially hazardous activities. I also have been informed, understand and aware that fitness activities involve risk of injury, including a remote risk of death or serious disability, and that I am voluntarily participating in these activities and using equipment and machinery with full knowledge, understanding and appreciation of the dangers involved. I hereby agree to expressly assume and accept any and all risks of injury or death.

I do hereby further declare myself to be physically sound and suffering from no condition, impairment, disease, infirmity or other illness that would prevent my participation or use of equipment or machinery. I do hereby acknowledge that I have been informed of the need for a physician’s approval for my participation in the exercise activities, programs, and use of exercise equipment. I also acknowledge that it has been recommended that I have yearly or more frequent physical examinations and consultations with my physician as to physical activity, exercise, and use of exercise equipment. I acknowledge that I have either had a physical examination and have been given my physician’s permission to participate, that I have decided to participate in the exercise activities, programs and use of equipment without the approval of my physician and do hereby assume responsibility for my participate in said activities, programs and use of equipment.

I understand that Macros Coach, LLC, Dustin M. Rhoads provision and maintenance of an exercise fitness program for me does not constitute an acknowledgement, representation or indication of my physiological well-being or a medical opinion relating thereto.

Accept Liability Disclaimer *

Certification

I acknowledge and provide Macroscoach LLC full release of Liability and I understand the expectations.