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Fertility Coaching Client Intake Form Template

Are you a fertility coach looking for an effective way to quickly and easily gather important information from your clients? Look no further! Our Fertility Coaching Client Intake Form Template is the perfect tool for you.


This customizable template makes it easier for you to collect important information such as contact information, medical history, and lifestyle habits. You can also add any additional questions that are relevant to your practice. All of this data can be quickly and easily organized so you can quickly assess your clients’ needs and provide the best care possible.


Our Fertility Coaching Client Intake Form Template will save you time and effort, while ensuring that all of the important information is collected in one place. With this form, you can create a comprehensive overview of your client’s health and lifestyle, and make sure that you have the information you need to provide the best possible care.


This template is easy to use and can be customized to meet your specific needs. You can add questions, change the order of the questions, and even add images or videos to the form. Plus, you can quickly and easily share the form with your clients, making it easier for them to fill out the form before their first appointment.

Fertility Coaching Client Intake Form Template

  1. Partner's name (if relevant):
  2. Address:
  3. What are your priorities around your health right now? What's important for me to know?
  4. Fertility - What has your experience been like so far? What tests and treatments have you already had?
  5. Menstrual Cycle - If you have a menstrual cycle what does it normally look like?
  6. Your Body - How do you feel about your body? What regular thoughts do you have around it?
  7. Food - What is your relationship with food like? What regular thoughts do you have around it?
  8. Accommodations - Do you have any specific accommodations or needs that I can support you with during our sessions?
  9. Anything else? - Is there anything else that is important for you that you’d like to share with me as we get started?
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