Welcome to [Your Coaching Business Name]! This intake form is designed to help us understand your needs, goals, and preferences so we can tailor our coaching services to best support you. Please take your time to complete this form thoroughly. All information provided will be kept confidential.
First Name
Last Name
Preferred Name
Phone Number
Email Address
Mailing Address
City
State/Province
Postal/Zip Code
Date of Birth
First Name
Last Name
Phone Number
Relationship
Type of Coaching (Check all that apply):
Individual Coaching
Group Coaching
Career Coaching
Life Coaching
Executive Coaching
Leadership Coaching
Wellness Coaching
Relationship Coaching
Financial Coaching
Spiritual Coaching
Other (Please specify):
Preferred Format:
In-Person
Virtual (Video Call)
Phone Call
Hybrid (Combination of In-Person and Virtual)
Frequency of Sessions:
Weekly
Bi-Weekly
Monthly
Other (Please specify):
Session Duration:
30 Minutes
60 Minutes
90 Minutes
Other (Please specify):
Preferred Days/Times for Sessions:
Morning
Afternoon
Evening
Weekdays
Weekends
Specific Days/Times:
What are your primary goals for coaching? (Check all that apply):
Career Advancement
Personal Growth
Improved Work-Life Balance
Enhanced Leadership Skills
Better Time Management
Increased Confidence/Self-Esteem
Health and Wellness Improvement
Financial Stability/Growth
Relationship Improvement
Stress Reduction
Other (Please specify):
Please describe your goals in more detail:
What do you hope to achieve by the end of our coaching engagement?
What challenges or obstacles do you currently face that may hinder your progress?
How do you prefer to measure success?
Have you worked with a coach before?
If yes, please describe your experience:
What motivates you to seek coaching at this time?
On a scale of 1-10, how committed are you to making changes in your life?
What is your preferred learning style?
Visual
Auditory
Kinesthetic
Reading/Writing
Other (Please specify):
Do you have any concerns or reservations about coaching?
Are there any specific cultural, religious, or personal considerations we should be aware of?
How would you describe your current level of stress?
Low
Moderate
High
Very High
Do you have any health conditions or concerns that may impact your coaching experience?
If yes, please describe:
Are you currently receiving any form of therapy or counseling?
If yes, please describe:
Do you have any dietary restrictions or preferences we should be aware of?
If yes, please describe:
Is there anything else you would like us to know about you?
How did you hear about us?
Referral
Social Media
Website
Event
Other:
I understand that coaching is a collaborative process, and my success depends on my active participation and commitment.
I understand that coaching is not a substitute for therapy, counseling, or medical advice.
I agree to the terms and conditions outlined in the coaching agreement.
I give permission for my coach to contact me via the provided contact information.
Client Signature:
Client Intake Form Insights
Please remove this client intake form insights section before publishing.
Below is a detailed breakdown of the Personal Growth Coaching Form, explaining the purpose and importance of each section and question. This form is designed to gather comprehensive information about the client, their goals, preferences, and readiness for coaching, ensuring a tailored and effective coaching experience.
This section collects basic demographic and contact details to establish clear communication and ensure the coach can reach the client when needed.
This section helps the coach understand the client’s expectations and preferences for the coaching process.
This section is the heart of the intake form, as it clarifies what the client hopes to achieve through coaching.
This section assesses whether the client is a good fit for coaching and their level of commitment.
This section ensures the coach is aware of any factors that may affect the client’s ability to fully engage in coaching.
This open-ended section allows the client to share anything else they feel is important.
This section ensures the client understands the nature of coaching and agrees to the terms of engagement.
This Client Intake Form is a powerful tool for creating a strong foundation for the coaching relationship. It ensures the coach has all the necessary information to provide effective, personalized support while also helping the client reflect on their goals and readiness for change.
To configure an element, select it on the form.