Elite Mind Architect | Lead with intention. Move with meaning.

Your Info

Full NameEmail

Section 1 — General Context

What's your #1 goal for the next 12 months?

Why is now the right time to upgrade your Human Operating System?

What would success look like at the end of these 17 weeks?

How many hours per week can you realistically commit to training, practices, and coaching?

Less than 3

3–5

6–8

9+

Section 2 — Pillar Experience

Rate your current consistency/experience in each area (1 = Never/brand new, 3 = Somewhat consistent/dabbled, 5 = Very consistent/advanced):

Section 3 — Pillar Reflections

Breath: How do you currently use your breath when stressed or tired?

Body: What types of movement feel most natural to you?

Mind: What is one recurring pattern of thought ("head trash") you'd like to shift or eliminate?

Nutrition: Walk me through a normal weekday's meals and drinks (morning to night).

Recovery: On a scale of 1–10, how rested do you usually feel when you wake up?

Section 4 — Lifestyle & Alignment

What does a typical workday look like for you (schedule, energy, stress)?

What kind of support system do you have at home or work for making changes?

Have you worked with a coach, guide, or program like this before? What worked, and what didn't?

Are you prepared to commit to 17 weeks of structured coaching?

Yes

No

This program requires honest communication and consistent engagement (journaling, reflection, showing up). Are you comfortable with that expectation?

Yes

No

Section 5 — Health & Safety

Age

Height

Weight

Do you have any injuries or physical limitations we should know about?

Do you have any medical conditions that could impact training?

Emergency contact (name + phone)

Medical Clearance Disclaimer:

This program includes physical training, breathwork, and recovery practices. By participating, you confirm that you are in good health and have been cleared by your physician to engage in an intensive 17-week training program.

I confirm the above.

Section 6 — Final Reflection

If you could design your ideal day — how you feel, move, think, eat, and recover — what would it look like?

Is there anything else you'd like me to know about your goals, challenges, or vision before we connect?

Human Operating System™ Boot Camp

Client Alignment Questionnaire