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Athena Tactics

Intake Form

Personal Information

Birthday
Month
Day
Year

Experience & Goals

Situational Awareness and Readiness

Are you comfortable handling simulated stressful scenarios?
Yes
No
Do you currently own a firearm?
Yes
No
Have you ever received firearms training before?
Yes
No
Are you interested in obtaining Firearm Legal Protection?
Yes
No

Health and Safety

Do you have any medical training?
Yes
No
Are you interested in taking a CPR course?
Yes
No
Are you interested in taking a STOP THE BLEED course?
Yes
No
Do you have any medical conditions or physical limitations that we should be aware of?
Yes
No
Are you currently taking any medications that could impact your ability to train or handle firearms?
Yes
No
Do you experience discomfort or physical limitations with prolonged standing or specific physical activities?
Yes
No
Do you have any hearing or vision impairments that we should be aware of during training?
Yes
No
Do you have any allergies or sensitivities (e.g., to noise, smells, or materials) that may affect your training?
Yes
No
Do you experience heightened anxiety or stress in high-pressure situations?
Yes
No
Do you have PTSD or a history of trauma that may affect your training experience?
Yes
No
Have you ever been a victim of abuse or an attack?
Yes
No

Additional Information

Are you Right Handed or Left Handed?
Right
Left

Acknowledgement & Signature

I confirm that the information provided above is accurate to the best of my knowledge. I understand that my participation in this program is voluntary, and I agree to adhere to all safety guidelines and instructions provided by Athena Tactics instructors.

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*Athena Tactics is here to support you. If you are in a dangerous situation and do not know how to communicate or are afraid to do so, we can help. We have local partners across the Treasure Valley and will get you the assistance you need*

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COPYRIGHT © 2022-2024 Athena Tactics, All rights reserved. No part of this publication can be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical or photocopying, recording, or otherwise without prior permission of the publisher.

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