HITMAN NUTRITION
HITMAN NUTRITION
Client Intake Form
828-855-6990
Hitmannutrition13@gmail.com
// Intake Form — Begin Here
YOUR PLANSTARTS NOW
Complete this form and we'll build a fully personalized plan around your goals, body, and lifestyle. Takes about 4 minutes.
Personal Body Lifestyle Health Diet Plan
// 01 of 06
PERSONAL INFO
Let's start with the basics.
Required.
Required.
Valid email required.
Required.
// 02 of 06
BODY METRICS
Accurate numbers let us calculate your exact caloric needs and training zones.
Required.
Required.

Activity Level
Sedentary
Lightly Active
Somewhat Active
Very Active

Body Goal
Lose Body Fat
Build Lean Muscle
Body Recomp
Maintain
Increase Strength
Improve Endurance
Flexibility & Mobility
Athletic Performance
Post-Injury Recovery
Post-Partum Recovery
Senior Fitness
Overall Health
// 03 of 06
LIFESTYLE & EQUIPMENT
We build your program around what you actually have access to.

Available Equipment
Bodyweight Only
Dumbbells
Barbell & Rack
Kettlebells
Resistance Bands
Pull-Up Bar
Cable Machine
Smith Machine
TRX / Suspension
Foam Roller
Jump Rope
Treadmill
Elliptical
Peloton / Bike
Rowing Machine
Stair Climber
Swimming Pool
Full Gym
Outdoor / Trails
Yoga Mat

Time Per Session
Under 30 min
30–45 min
45–60 min
60–90 min
90+ min
// 04 of 06
HEALTH HISTORY
Keeps your plan safe and built around your real body.

Medical Conditions
None
Pre-Diabetes / High A1C
Type 2 Diabetes
Type 1 Diabetes
High Blood Pressure
High Cholesterol
Heart Disease
Asthma / COPD
Arthritis
Osteoporosis
Thyroid Condition
PCOS
Menopause
Metabolic Syndrome
Depression / Anxiety
Sleep Apnea
Kidney Disease
Autoimmune
Prefer Not to Say

Injuries / Joint Issues
No Injuries
Knee Pain
Lower Back Pain
Upper Back / Neck
Shoulder Issues
Hip Pain
Ankle Issues
Plantar Fasciitis
IT Band Syndrome
Elbow Pain
Wrist Pain
Herniated Disc
Sciatica
ACL / MCL / Meniscus
Joint Replacement
Other Surgery
Chronic Pain
// 05 of 06
DIET & GOALS
Your food preferences and what you actually want to achieve.

Diet Style
No Preference
Standard American
Southern / Soul Food
High Protein
Low-Carb / Keto
Mediterranean
Fish & Seafood
Plant-Based / Vegan
Vegetarian
Paleo
Intermittent Fasting
Gluten-Free
Dairy-Free
Halal
Kosher
Budget / Meal Prep
Latino / Hispanic
Asian Cuisine

Top Goals
Lose Body Fat
Build Lean Muscle
Body Recomposition
Increase Strength
Heart Health
Lower A1C
Lower Blood Pressure
Endurance / Stamina
Athletic Performance
Sport-Specific
More Energy
Better Sleep
Reduce Stress
Reduce Joint Pain
Post-Injury Rehab
Flexibility / Mobility
Better Posture
Avoid Medications
Weight Gain / Bulk
Post-Partum Recovery
Senior Fitness
Mental Health
Overall Longevity
0/500
// 06 of 06
CHOOSE YOUR PLAN
Select the tier that fits where you are right now.
T1 // THE BLUEPRINT
THE BLUEPRINT
Nutrition-only. Your personalized macro targets, meal structure, and food list — built for your goal. Bonus starter training schedule included.
Nutrition PlanMacro TargetsMeal StructureFood ListDigital PDF
$25/mo
T2 // THE FULL PLAN
THE FULL PLAN
Everything in The Blueprint plus a complete 4-week training program tailored to your equipment and goals.
Nutrition Plan4-Week TrainingEditable PDFEquipment-Specific
$40/mo
T3 // THE ELITE PLAN
THE ELITE PLAN
Everything in The Full Plan plus a supplement protocol, editable PDF, and a Week 2 check-in where we review and adjust.
Full PlanSupplement ProtocolWeek 2 Check-InEditable PDF
$65/mo
T4 // NEXT LEVEL COACHING
NEXT LEVEL COACHING
Everything in The Elite Plan plus weekly check-ins all month and a full end-of-month review with next-step recommendations.
Elite PlanWeekly Check-InsMonth-End ReviewAlways Available
$100/mo
TARGET ACQUIRED
Your intake form has been submitted to Hitman Nutrition. We'll review your info and reach out within 48 hours to get your plan started.

Questions? Call or text 828-855-6990 or email Hitmannutrition13@gmail.com
// Step 2 — Complete Your Payment
SECURE YOUR SPOT
Your plan won't be started until payment is confirmed. Send your payment using the option below.
Selected Plan:
Amount Due:
Pay via Cash App
$Noahslaw3
Pay Now
// Coming Soon
More payment options including Venmo, Zelle, Square, and credit/debit card checkout will be available soon.
After sending payment, include your name and selected plan in the note so we can match it to your intake.
Questions about payment? Text us at 828-855-6990