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AKMI Human Performance
Client Intake Form

Your Coaching Journey Starts Here

Complete this form to help your coach create your personalized assessment, training, and nutrition protocol. All information is confidential. The more detail you provide, the better we can customize your program.

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Basic Profile
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Goals
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Training History
4
Injuries & Medical History
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PDF, JPG, PNG, DOC, DOCX
5
Nutrition
6
Sleep, Stress & Lifestyle
7
Photos & Video

Upload clear photos in minimal clothing (shorts + fitted top). Good lighting, plain background. You may upload multiple photos per category.

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Click to upload
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Click to upload
Both feet: front, back, left side, right side -- 4 to 8 photos
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Multiple files accepted
Record yourself walking naturally. Walk AWAY from the camera for ~5 seconds, then turn and walk BACK toward it. Full body must be visible head to feet. Camera at hip height, 3-4 meters away. If possible, record a second video from the SIDE view.
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Click to upload or drag and drop
MP4, MOV, AVI
8
Footwear
Both sides (left and right), heel view, and sole (bottom view)
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Click to upload
Multiple files accepted
Both sides (left and right), heel view, and sole (bottom view)
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Click to upload
Multiple files accepted
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Additional Information
10
Optional Documents

If you have these, upload them. If not, skip this section.

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PDF, JPG, PNG, XLSX, DOC
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PDF, JPG, PNG
I confirm that the information provided is accurate to the best of my knowledge. I understand this data will be used exclusively by my coach to create my personalized program. My data is confidential and will not be shared with third parties.
All data encrypted & confidential
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Thank You

Your intake form has been received. Your coach will review it and contact you within 24-48 hours to discuss your assessment and next steps.