Client Assessment | Kill To Live

01Applicant Information

Email Address

Full Name

Phone Number

Age

Weight

Height

02Your Mission

MISSION STATEMENT: Explain your specific fitness goals. What do you want to achieve, why does it matter to you, and what would accomplishing these goals change in your life?

What would NOT meeting these goals mean for you in your life? How would this failure impact you and those around you?

What best describes your primary motivation?

I want to improve my health and build better habits.I have specific physical or performance goals.I am ready for a significant lifestyle transformation.I need structure, coaching, and accountability.

How long have you been working toward these goals?

I am just getting started.Less than 6 months.6 months to 2 years.More than 2 years.

03Discipline & Accountability

When motivation disappears, what do you typically do?

I stop until I feel motivated again.I struggle but eventually restart.I follow my plan even when I do not feel like it.I seek accountability and adjust my approach.

How do you respond to direct, constructive feedback?

I often take it personally.I sometimes struggle but remain open.I welcome feedback that helps me improve.I actively seek correction and accountability.

Are you willing to track workouts, progress, and habits?

Yes, consistently.Yes, but I may need guidance.I am unsure.No.

04Operational Readiness

What is your current training experience?

BeginnerIntermediateAdvancedReturning after an extended break

Do you have any injuries, medical restrictions, or physical limitations that may affect training?

No known limitations.Yes, and I can discuss appropriate accommodations.I am unsure and may need medical guidance.Prefer to discuss privately.

What equipment or facilities can you access?

Full gymHome gym or basic equipmentBodyweight training onlyNot sure yet

05Commitment Under Pressure

What is your greatest obstacle to consistency?

Describe a time when you faced a difficult challenge and followed through despite wanting to quit.

Are you prepared to make sustainable changes to your daily routine?

Yes, I am ready to commit.Yes, with coaching and support.I am still evaluating my readiness.Not at this time.

06Final Accountability Check

Why should KILL TO LIVE invest coaching time and attention in helping you reach your goals?

Do you understand that results require consistent effort, honest communication, and personal responsibility?

Yes, I understand and accept responsibility.I would like to discuss expectations before committing.

Client
Intake

01Applicant Information

02Your Mission

03Discipline & Accountability

04Operational Readiness

05Commitment Under Pressure

06Final Accountability Check

Received.
Now prove it.

01Applicant Information

02Your Mission

03Discipline & Accountability

04Operational Readiness

05Commitment Under Pressure

06Final Accountability Check

Received.Now prove it.

Received.
Now prove it.