Onboarding Intake | Embrace Body FN

ChatGPT Image Sep 4, 2026 at 12_52_31 PM.png

Home
Wellness Services
New Member Portal
- Onboarding Page Membership
- Onboarding Intake
My Account
Wellness Community
Insurance
Refer Friends

Use tab to navigate through the menu items.

View points

Personal Information

First Name*

Last Name*

Date of Birth*

Month

Day

Year

Phone Number*

Email Address*

Emergency Contact Name*

Emergency Contact Phone Number*

Relationship to Emergency Contact*

Health History

Do you have any current injuries or physical limitations?*

Yes

If yes, please describe your injuries or physical limitations

Do you have any medical conditions we should be aware of?*

Yes

If yes, please describe your medical conditions

Are you currently taking any medications?*

Yes

If yes, please list your current medications

Have you had surgery in the past 12 months?*

Yes

If yes, please describe the surgery and your current recovery status

Are you currently pregnant or postpartum?*

Yes

Are you currently working with a physician or healthcare provider?*

Yes

If yes, please share any relevant details or restrictions from your provider

Goals & Session Info

What are your primary wellness goals?*

What service are you booking?*

How did you hear about Embrace Body?

FSA/HSA Benefits

Are you using FSA/HSA benefits for this service?*

Yes

Consent & Liability Waiver

Please read the following agreement in full before signing.

1. Description of Activities

I understand that by participating in services offered by Embrace Body Fitness & Nutrition LLC, including but not limited to one-on-one personal training, small-group fitness training, nutrition education and counseling, macro and nutrition coaching, InBody body composition assessments, Styku 3D body scans, wellness and metabolic health assessments, and HealthPass by Styku, I am voluntarily engaging in physical and wellness activities that carry inherent risk.

2. Assumption of Risk

I acknowledge that participation in fitness, wellness, and body assessment activities involves the risk of physical injury, including but not limited to muscle strains, sprains, joint injuries, cardiovascular events, and other physical harm. I voluntarily assume all risks associated with my participation, whether those risks are known or unknown to me at this time.

3. Medical Clearance

I confirm that I am physically capable of participating in the services I have selected. I have disclosed any known medical conditions, injuries, medications, or physical limitations on this intake form. I understand that it is my responsibility to consult with a licensed physician before beginning any fitness or nutrition program, particularly if I have a pre-existing medical condition, am pregnant or postpartum, or have had surgery within the past 12 months.

4. Release of Liability

In consideration of being permitted to participate in Embrace Body's services, I hereby release, waive, and discharge Embrace Body Fitness & Nutrition LLC, its owner, staff, contractors, and representatives from any and all claims, demands, losses, damages, or causes of action arising out of or related to my participation, including those caused by negligence, to the fullest extent permitted by law.

5. Nutrition & Wellness Disclaimer

I understand that nutrition coaching, macro coaching, and wellness assessments provided by Embrace Body are for educational and informational purposes only and do not constitute medical advice, diagnosis, or treatment. I agree to consult a licensed healthcare provider before making significant changes to my diet or health regimen.

6. Body Assessment Consent

I consent to the use of InBody and Styku body composition and 3D scanning technology. I understand these assessments are non-invasive and provide data for wellness tracking purposes only. Results are not a medical diagnosis.

I have read the full Liability Waiver & Informed Consent Agreement above. I voluntarily agree to assume the risks of participation and release Embrace Body Fitness & Nutrition LLC, its owner, staff, contractors, and representatives from any and all liability to the fullest extent permitted by law.

I grant Embrace Body Fitness & Nutrition LLC permission to photograph or video record me during sessions or assessments for use in marketing, social media, and promotional materials. I waive any right to compensation or approval of such use. (Optional)

I confirm that I am 18 years of age or older (or have parental/guardian consent) and that all information provided in this form is accurate and complete to the best of my knowledge.

Digital Signature*

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Date*

Month

Day

Year

Faith-Fueled. Wellness-Driven. Empowering Women, Athletes & Families to Prevent, Protect & Prosper.

Subscribe Form