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Health Coaching Intake Form Template

Welcome health professionals! Are you looking for a comprehensive intake form to help you gather the information you need from your clients? Look no further! Our Health Coaching Intake Form Template is designed to help you efficiently collect a range of information from your clients.

Our template is comprehensive and includes questions that cover the client's medical history, lifestyle, and goals. This information is essential to understand the client's health and develop a plan that is tailored to the individual.

The form is simple and easy to use, itt can be filled out in a matter of minutes. This allows you to create a reliable and accurate medical history for each of your clients.

The Health Coaching Intake Form Template is a great way to get to know your clients quickly and efficiently. It will help you create a personalized health plan for them and provide the best possible service. Try it out today and streamline the intake process for your health coaching clients!

Health Coaching Intake Form Template

  1. First Name:
  2. Last Name:
  3. Date of Birth (dd/mm/yyyy):
  4. Phone Number:
  5. Email Address:
  6. Address:
  7. City:
  8. State/Province:
  9. Postal code:
  10. Country:
  11. Which area(s) of your health and wellness do you think could benefit from coaching?
  12. What health and wellness challenges are you currently facing that you think would benefit from coaching? Use the space
    below to describe at least two areas where you are having trouble.
  13. Describe what the best case scenario would look like for you after you have successfully overcome
    these obstacles.
  14. List any interests or hobbies you enjoy doing.
  15. What do you think are your best qualities? (please describe or list them below)
  16. Is there any quality that you have not listed above which you would like to improve? (please describe or list these qualities below)
  17. What's your vision for your health and wellness?
  18. How can coaching help you achieve the vision you desire?
  19. What do you do when you are stressed out?
  20. What do you find helps you when you are struggling to move forward? (please describe an approach or tactic that works best to help get you going)
  21. Is there anything else you’d like to add that you think we've missed?
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