Welcome to Clark 4 Wellness!

We're here to help busy parents and professionals take control of their health and build a life of discipline, strength and purpose.

Tell us more about you so we can see where we can help in your journey!

First Name *

Last Name *

Email *

Phone *

Date of birth

Preferred Contact Method:

What are your primary fitness goals?

Lose Weight

Build Muscle

Improve Cardiovascular Health

Maintenance

Do you have any specific fitness challenges or limitations we should be aware of?

Do you have a timeline in mind to reach your goals? (please describe)

Have you worked with trainers or coaches in the past?

Do you have access to a gym?

What's your current activity level?

How many hours can you dedicate to your fitness each week?

What type of workouts do you enjoy? (Check all that apply)

Do you track your food or do you have experience with nutrition plans?

Do you drink caffeine, alcohol or take supplements regularly?

Do you get enough sleep each night? Do you feel well rested?

Are you interested in peptides or hormone optimization?

How do you like to be held accountable?

What motivates you more?

How did you hear about us?

Thank you for completing the intake form! We look forward to helping you achieve your goals.

After submitting your answers, please choose a time that works best for your free consultation.