Corporate Wellness Seminars
Client Intake Form

A group of employees engaged in a team building activity during a wellness seminar.

I. Company Information

Company Name:

Company Address:

City/Suburb

State/Province

Postal/Zip Code

Contact Person:

Contact Person Title:

Phone Number:

Email Address:

Company Industry:

Number of Employees:

Primary Company Goals for Wellness Program:

Current Wellness Initiatives, if any:

 

II. Seminar Logistics and Preferences

Preferred Seminar Format:

In-person

Virtual (Live Webinar)

Hybrid (In-Person & Virtual)

Please specify any platform requirements for virtual seminars:

Preferred Seminar Dates/Times: (Please provide a range of dates and times that work best):

 

1 st choice

2nd choice

3rd choice

4th choice

Seminar Duration:

30 minutes

45 minutes

1 hour

Other (Please specify):

Preferred Seminar Frequency:

One-time event

Monthly

Quarterly

Other (Please specify):

Target Audience for Seminars:

All employees

Specific departments

Leadership team

Other (Please specify):

Estimated Number of Participants per Seminar:

Preferred Language(s) for Seminars:

Any Accessibility Requirements for Participants:

Hearing impairments

Visual impairments

Physical disabilities

Other (Please specify):

Budget for Wellness Seminars:

Do you have a space to hold the seminars onsite?

If yes, please describe the space:

III. Seminar Topic Preferences

 

Please indicate your level of interest in the following seminar topics:

(Use a rating scale: 1 = Not Interested, 2 = Slightly Interested, 3 = Moderately Interested, 4 = Very Interested, 5 = Extremely Interested)

Seminar Topic

Rating

(1 = Not Interested, 5 = Extremely Interested)

A
B
1

Mental & Emotional Wellbeing:

 
2

Stress Management

3

Building Resilience

4

Mindfulness & Meditation

5

Work-Life Balance

6

Emotional Intelligence

7

Managing Anxiety & Depression

8

Burnout Prevention

9

Improving Sleep Hygiene

10

Physical Health & Nutrition:

11

Healthy Eating Habits

12

Nutrition for Energy & Productivity

13

Weight Management

14

Introduction to Fitness

15

Ergonomics & Workplace Posture

16

Preventing Workplace Injuries

17

Importance of Hydration

18

Cooking Demonstrations for healthy meals

19

Productivity & Performance:

20

Time Management & Productivity

21

Effective Communication Skills

22

Team Building & Collaboration

23

Goal Setting & Achievement

24

Leadership Development

25

Managing Distractions

26

Financial Wellness:

27

Budgeting and Financial Planning

28

Retirement Planning Basics

29

Managing Debt

Other Wellness Topics:

Please list any other wellness topics your company is interested in:

IV. Additional Questions

What are the biggest wellness challenges your employees currently face?

Are there any specific concerns or issues you would like the wellness seminars to address?

What metrics will you use to measure the success of the wellness seminars?

How will you promote the wellness seminars to your employees?

Do you have any existing employee feedback or survey data regarding wellness needs?

Is there anything else you would like to add or discuss?

 

Thank you for completing this form. We will review your information and contact you to discuss your company's wellness needs.

 

Form Template Insight

Please remove this form template insight section before publishing.


Important Considerations:

  • Customization: This form is a template. Customize it to fit your specific services and the needs of your target clients.
  • Data Privacy: Ensure you comply with all data privacy regulations (e.g., GDPR, CCPA) when collecting and storing client information.
  • Professionalism: Maintain a professional tone and appearance in your forms and communications.

Let's break down this Corporate Wellness Seminars Client Intake Form section by section, providing detailed insights into its purpose and importance:


I. Company Information:


Purpose: This section establishes a foundational understanding of the client company. It gathers essential contact information, industry details, and the company's overall wellness objectives.

Importance:

  • Relationship Building: It initiates a professional relationship and helps you personalize your approach.
  • Contextual Understanding: Knowing the industry and company size helps tailor seminar content and delivery.
  • Goal Alignment: Understanding their wellness goals ensures your seminars contribute to their strategic objectives.
  • Current Initiatives: Knowing what they are already doing allows you to avoid overlap and add value.

Key Considerations:

  • Ensure the contact person is the primary decision-maker or has the authority to represent the company's wellness needs.
  • The "Primary Company Goals" question is crucial for aligning your services with their desired outcomes.

II. Seminar Logistics and Preferences:


Purpose: This section focuses on the practical aspects of seminar delivery, ensuring a smooth and effective experience.

Importance:

  • Logistical Planning: It helps you determine the best format, timing, and frequency for the seminars.
  • Accessibility: Addressing accessibility requirements ensures inclusivity and participation for all employees.
  • Resource Allocation: Understanding the target audience and estimated participant numbers helps you allocate resources appropriately.
  • Budgetary Constraints: While optional, the budget information can help you tailor your offerings to fit their financial parameters.
  • Space availablity: If you are doing in person seminars, it is vital to know if the client has a space to hold the seminars.

Key Considerations:

  • Offer a variety of format options (in-person, virtual, hybrid) to cater to different preferences and company structures.
  • Be flexible with scheduling and accommodate the client's preferred dates and times as much as possible.
  • Clearly define what platforms you use for virtual meetings, and make sure that the client can access them.

III. Seminar Topic Preferences:


Purpose: This section is the heart of the intake form, allowing the client to express their specific interests and needs.

Importance:

  • Customization: It enables you to tailor seminar content to address the company's most pressing wellness concerns.
  • Engagement: Offering relevant topics increases employee engagement and participation.
  • Needs Assessment: The rating scale provides valuable data on the popularity and perceived importance of different wellness topics.
  • Identifying Gaps: It helps identify areas where the company may need additional support or education.

Key Considerations:

  • Provide a comprehensive list of seminar topics covering various aspects of wellness (mental, physical, financial, productivity).
  • Use a clear and consistent rating scale to facilitate accurate data collection.
  • Include an "Other" option to allow clients to suggest topics not listed.
  • The cooking demonstration option is a great way to add a practical application to your nutrition seminars.

Topic Grouping: the grouping of topics makes it easier for the client to select the catagory that they are most interested in.


IV. Additional Questions:


Purpose: This section delves deeper into the company's specific challenges, concerns, and expectations.

Importance:

  • Problem Identification: It helps you identify the root causes of wellness issues within the company.
  • Solution Development: It provides valuable insights for developing targeted and effective seminar content.
  • Outcome Measurement: It facilitates the establishment of clear metrics for evaluating the success of the wellness program.
  • Promotion Planning: Knowing how they will promote the seminars helps you know how many people to expect.
  • Pre-existing data: Knowing if they have pre-existing data, helps you to avoid duplicating work, and allows you to build upon their current data.

Key Considerations:

  • Ask open-ended questions to encourage detailed responses.
  • Focus on gathering actionable information that can be used to improve the wellness program.
  • Emphasize the importance of measuring the success of the seminars to demonstrate their value.

V. Follow-Up:


Purpose: This section establishes clear communication channels and ensures a smooth transition to the next phase of the process.

Importance:

  • Efficient Communication: It streamlines communication and ensures timely responses.
  • Professionalism: It demonstrates your commitment to providing excellent customer service.

Key Considerations:

  • Offer multiple communication options to cater to different preferences.
  • Specify a preferred time for contact to avoid unnecessary delays.

Overall Insights:

  • This intake form is designed to be comprehensive and thorough, providing a holistic understanding of the client's wellness needs.
  • It emphasizes customization, collaboration, and data-driven decision-making.
  • By using this form effectively, you can build strong client relationships and deliver impactful wellness seminars that contribute to the overall success of the company.
  • It is vital to review the information provided by the client, and to then use that information to create a wellness program tailored to the clients needs.
  • By having this information, you are able to show the client that you are listening to their needs, and providing a service that will benifit the company.

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