Health Coach Intake Form

Health Coach Intake Form

Last updated July 27th, 2023

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A health coach intake form is used to gather relevant information about a client before starting a coaching program or session. The form will typically include a series of questions regarding the client’s physical and mental well-being. Intake forms are an essential step in the coaching process that helps the health coach understand the client’s health concerns, current lifestyle, goals, and obstacles.

Types of Health Coaches

There are three general types of health coaches:

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


Requested Information

To properly address a client’s concerns, an intake form will usually demand the following information:

  1. Personal Information
    • The client will be asked to provide their basic details, such as name, age, contact information, preferred method of communication, and emergency contact phone number.
  2. Goals
    • The form will often ask the client to explain their motivation for seeking coaching, including specific concerns and what they expect to achieve through the coaching process.
  3. Change
    • Descriptions of any obstacles the client faces to improving their health and well-being will typically need to be provided. This information can help the health coach develop strategies to overcome these challenges.
  4. Environment
    • It’s useful for the health coach to know the client’s environmental factors, such as their job and living situation.
  5. Time, Stress, and 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.
  6. Health Markers
    • The form may ask questions about the client’s medical history, including any previous injuries, surgeries, or medications.
  7. Disclaimer
    • The intake form often has a disclaimer warning clients that they should consult their doctor before following a health coaching program.

First Assessment

A first assessment typically focuses on understanding the client’s current health, goals, and any challenges they face. Some of the key elements that may be addressed in an initial assessment include the following:

  • Introduction – The health coach will introduce themselves and explain their general approach to working with clients and the confidentiality of sessions. The client will often be asked if they have any initial questions before proceeding.
  • Review of intake formThe completed form can be reviewed and the health coach will ask for clarification where necessary to understand the client’s current situation and needs thoroughly.
  • Goal-setting – The coach and client will discuss the client’s goals, desired outcomes, and expectations for their coaching experience. Based on the client’s objectives and motivation level, the health coach will develop an action plan and timeline for them to follow.
  • Next steps – Before the end of the session, the coach will usually explain what the next steps of the coaching process will be. If the client approves of the proposed schedule for future sessions, they may schedule the next appointment.
  • Homework – The coach will often give the client materials and “homework” to do before the next session.

Related Forms (3)

Life Coaching Client Intake Form – Used by life coaches to gather information from new clients before their first session.

Download: PDFWord (.docx)OpenDocument


Personal Training Client Intake Form – Used by personal trainers to collect relevant information from new clients.

Download: PDFWord (.docx)OpenDocument


Physical Therapy Intake Form – Allows physical therapists to collect patient information before treatment begins.

Download: PDFWord (.docx)OpenDocument