📋 Pre-Session Intake Form

Full Name

Email *

Phone *

Preferred Method of Communication:

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Intro Text:
Welcome! This form is designed to help us get to know you better and prepare for your first session. Please answer as openly as you feel comfortable—everything you share will be kept confidential.

How would you describe your current overall health?

Are you currently experiencing any physical discomfort or limitations?

Do you have any existing diagnoses or conditions we should be aware of?

Current stress level (1–10):

Sleep quality (1–10):

What inspired you to join this program?

What are your top 3 goals for the next 90 days?

What challenges have you faced in achieving these goals before?

How do you want to feel after completing this program?

What kind of support do you value most?

Anything else you’d like your coach to know before your first session?

Closing Text:

Thank you for completing this form. Your responses will help us make your first session focused, personalized, and powerful.