New Client Intake — Midtown Biohack™

Welcome to Midtown Biohack™

This form takes about 5 minutes. Your information is stored securely and shared only with your assigned coach and Dr. Morris.

Step 1 of 6

Personal Information

First Name *

Last Name *

Email Address *

Phone Number

Date of Birth

Biological Sex

Step 2 of 6

Emergency Contact

Contact Name

Relationship

Contact Phone

Step 3 of 6

Health History

Be thorough — this helps your coach design the safest and most effective program for you.

Current Medications

Known Allergies

Previous Injuries, Surgeries, or Chronic Conditions

Current Pain or Discomfort

Step 4 of 6

Your Goals

Be specific — the more clearly you describe what you want, the better we can help you get there.

Primary Goal — What Do You Most Want to Achieve? *

What Have You Already Tried?

Preferred Location

How Did You Hear About Us?

Step 5 of 6

Lifestyle

Average Sleep Per Night

Activity Level

Average Stress Level

Diet Style

Step 6 of 6

Consent & Agreement

Recovery Optimization — Not Medical Care
Midtown Biohack™ and the Morris Method™ platform provide recovery optimization and performance coaching services only. We are not a medical practice and do not provide medical care, medical advice, diagnosis, or treatment of any kind. Always consult a licensed physician for medical concerns. In case of emergency, call 911.

Digital Signature — Type Your Full Legal Name *

By submitting this form, your typed name serves as your digital signature confirming all consent above. Submitted: