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The System
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Welcome
New client intake
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Contact
Full name
Preferred name
Date of birth
Phone
Email
Address
Emergency contact name
Emergency contact relationship
Emergency contact phone
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Membership
Tier
Foundation — 2x/week
Core — 3x/week
Elite — 4x/week
Agreement
12-month
Month-to-month
Preferred days
Mon
Tue
Wed
Thu
Fri
Sat
Preferred times
Early AM (5:30–8)
Mid AM (8–11)
Midday (11–2)
Afternoon (2–5)
Evening (5–8)
Start date
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Goals
Why now?
What would a win look like six months from now?
How will you know this is working, other than the scale?
What has stopped you before?
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Acknowledgments
I will complete the Health History Questionnaire before my first session.
I have read and signed the Assumption of Inherent Risk and Release.
I have read and signed the Informed Consent.
I have read and agree to the Membership Agreement and Terms of Service.
I understand Muscle Mommy Coaching does not diagnose or treat medical conditions, does not manage hormone therapy, and does not provide physical therapy or medical nutrition therapy.
Type your full name as signature
Signature date
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