ATHLETE SERVICES
1:1 TRAINING
GROUP TRAINING
YOUTH
TECH SOLUTIONS
COACHES
COMPANIES
Toggle menu
Toggle menu
Step 1 of 12
8%
Name
*
First
Last
Date of Birth
*
Height
*
In inches
Weight
*
In pounds
Athletic History
Please tell us about your past and present athletic activities
*
Add more rows with the + if needed.
Sport/Activity
Years of Participation
Additional Details or Info
Training History
Please tell us what your training regiment has consisted of over the last 6 months
*
Do you currently have a warm up that you do consistently?
*
Yes
No
Please tell us about your warm up
*
Do you currently have a recovery plan post workout?
*
Yes
No
Please tell us about your recovery plan
*
Do you currently work on mobility outside of your warm up / recovery plan?
*
ie Rest days, specific mobility days, ROM WOD
Yes
No
Please tell us about your mobility work
*
Goals
What athletic goals do you have (long or short term)?
*
How many days a week would you like programming for?
1
2
3
4
5
6
7
How much time can you allot to training each day?
Will HELIYO programming be your only training or do you plan on having additional forms of exercise?
Yes
No
Please describe all other training activities in addition to HELIYO programming
Equipment
Please check off all equipment you have available for your training
*
Kettlebells
Medicine Balls
Dumbbells
Barbell
Weighted Plates
TRX
Resistance Bands/Tubing (With Handles)
Resistance Bands (Circular)
Mini Bands (Circular)
Pull Up Bar
Squat Rack
Weight Bench
Rowing Machine
Stationary Bike
Fan Bike
Treadmill
Other
What weight kettlebells do you have?
*
2 x 15lbs, 1 x 25lbs, OR 5-50lbs etc...
What weight medicine balls do you have?
*
2 x 10lbs, 1 x 20lbs, etc...
What weight dumbbells do you have?
*
2 x 15lbs, 1 x 25lbs, OR 5-50lbs etc...
What weight barbells do you have?
*
1 x 15lbs, 1 x 45lbs etc....
What weighted plates do you have?
*
4 x 10lbs, 4 x 20lbs, OR 5-45lbs etc...
What weight equivalents do you have for resistance tubing/bands?
*
2 x 10lbs, 2 x 20lbs, etc...
Please describe other equipment that you have
*
Movements
Please tell us about movements you LOVE and why you LOVE them
Please tell us about movements you HATE and why you HATE them
Lifestyle
What is your occupation?
*
Different occupations effect the body in varying ways, this will allow us to customize your warm ups and training accordingly.
Do you currently follow a nutritional plan?
*
Yes
No
Please describe your current nutritional plan?
*
What is your preferred method of communication with HELIYO?
Text
Email
No Preference
Surgeries and Medical Procedures
Have you experienced an surgeries/medical procedures in the past?
*
Yes
No
Please list all surgeries and/or medical procedures below
*
Add more rows with the + if needed.
Date of Surgery/Procedure
Type of Surgery/Procedure
What Cause/Event Lead to This?
Resolved or Ongoing Condition?
Injuries
Have you experience any injuries in the past?
*
Injuries involving muscles, tendons, ligaments, and bones
Yes
No
Please list all injuries below
*
Add more rows with the + if needed.
Date of Injury
Type of Injury
How Did Injury Take Place?
Resolved or Ongoing?
Serious Health Conditions
Have you experienced any serious health conditions in the past?
*
Yes
No
Please list all health conditions below
*
Add more rows with the + if needed.
Date of Health Condition
Type of Health Condition
Resolved or Ongoing Condition?
Do you have any additional health information that you would like to disclose?
*
Yes
No
*
Current State of Your Body
Are you currently experiencing any aches and/or pains?
*
Yes
No
Please list all aches and/or pains
*
Add more rows with the + if needed.
Location
Description of Pain/Ache
Date of Onset
How did it start?
Does a physician or physical therapist currently monitor or prescribe exercises for you?
*
Yes
No
If yes please describe who and what for
*
Anything else you would like to tell us about the current state of your body?
*
Yes
No
If yes, please elaborate
*
*
I've read and accept HELIYO's
terms of service
.
*
I have completed and would like to submit my intake
Signature
*