Health Coach Intake Form

A health coach intake form gathers information about a client before starting a coaching program or session. It includes a series of questions about the client’s physical and mental well-being that help the coach understand the client’s health concerns, current lifestyle, goals, and obstacles.

Health Coach Intake Form

A health coach intake form gathers information about a client before starting a coaching program or session. It includes a series of questions about the client’s physical and mental well-being that help the coach understand the client’s health concerns, current lifestyle, goals, and obstacles.

Last updated September 30th, 2024

A health coach intake form gathers information about a client before starting a coaching program or session. It includes a series of questions about the client’s physical and mental well-being that help the coach understand the client’s health concerns, current lifestyle, goals, and obstacles.

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Types of Health Coaches

  • Standard Health Coach – Works in partnership with their clients to set goals and implement sustainable strategies to achieve their health objectives.
  • Holistic Health Coach – Applies a holistic approach to help clients improve their mental and physical health, addressing nutrition, fitness, relationships, and spirituality.
  • Wellness Health Coach – Unlike other health coaches, wellness coaches aren’t necessarily goal-orientated and are primarily concerned with helping clients achieve well-being and balance.

Requested Information

Personal Information

The client will be asked to provide basic details, such as their name, age, contact information, preferred method of communication, and emergency contact phone number.

Goals

Providing an explanation of why they are motivated to work with a coach will allow the instructor to understand what they want to achieve and how to address any concerns.

Habits

The form should include the client’s habits, choices, and barriers that have led them to seek a health coach. This information can help the health coach develop strategies to overcome these challenges.

Environment

It’s useful for the health coach to know the client’s day-to-day environment, such as their job and living situation.

Time, Stress, & Recovery

Questions related to time management, stress, emotional well-being, and mental health are commonly included to gain a comprehensive understanding of the client’s mental state.

Health Markers

The client should list any injuries, illnesses, or operations they have had as well as medications they have taken or are currently taking.

Disclaimer

A disclaimer is on the form to warn clients that they should consult their doctor before following a health coaching program.

Health Coach Intake Form (Preview)