Coaching Intake Questionnaire

I want to get to know you.
You're unique and so is your coaching journey. So help me learn about you. We’re in this together, starting today.

Take this time for yourself.
This questionnaire should take about 10-15 minutes. Consider it your first coaching step and an investment in yourself.

Don’t worry, I am good at keeping your secrets.
I take your privacy very, very seriously. Everything you tell me is confidential.


What are Your Goals?

Everyone has their own reasons for working on their health and fitness. Tell me what you hope to get out of this

How would you rate the following goals on a scale of 1 to 10?
(Where 1 is a low priority for you, and 10 is the highest priority for you.)


How much would you like to…

If you had to choose between the following 4 goals, which one is most important to you?
Tell me about Your Nutrition and Exercise Habits
Your Contact Information
Your Name
Your Name
Address
Address
Phone
Phone