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Kosta Kromidas
Longevity & Performance Coaching
About
Services
Work With Me
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Kosta Kromidas
Longevity & Performance Coaching
About
Services
Work With Me
New Client Intake Form
Please fill out the enitre form and hit submit at the bottom of the page. Once your form has been submitted, I will review your form and reach out to you directly.
New Client Intake Form
First Name
Last Name
Client Age
Patient Gender
- Select -
Male
Female
Others
Phone no.
Email
Coaching Interest (Select all that apply to your needs)
Strength Training
Nutrition Coaching
Fat Loss / Body Recomposition
Muscle Building
Hormone Optimization Education
Longevity / Health Optimization
Primary goals
Build muscle
Lose fat
Improve energy
Improve health / longevity
Improve athletic performance
Hormone optimization support
Current Fitness Level
- Select -
Beginner
Intermediate
Advanced
Current Training Routine and Diet Approach
Do you have recent blood work?
Yes
No
Are you currently working with a doctor or specialist?
Yes
No
Current List of Medications
Have you ever used TRT or hormone optimization therapy?
Yes, Previously
Yes, Currently Right Now
No
If Yes, please provide more details
Are you interested in learning about hormone optimization under medical supervision?
Yes
No
Maybe
Any Injuries or medical limitations?
Anything else you would like us to know?
I understand that this coaching service provides fitness, nutrition, and wellness guidance and does not replace medical advice, diagnosis, or treatment. I will consult my physician before making changes to training, diet, supplements, or hormone-related decisions.”
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