Full Name
Date of Birth
Gender
Address
Phone Number
Full Name
Phone Number
Relationship
Please list any current medical conditions or injuries:
Are you currently taking any medications?
Do you have any allergies?
Have you had any recent surgeries?
Are you currently pregnant or postpartum?
Do you experience any of the following? (Check all that apply)
Back Pain
Neck Pain
Joint Pain
Headaches/Migraines
Dizziness
Heart Conditions
High/Low Blood Pressure
Respiratory Issues (Asthma, etc.)
Other (Please specify):
Do you have any limitations or restrictions that may affect your ability to participate in yoga or pilates?
Have you been cleared by a medical professional for physical activity?
What is your current level of physical activity?
Sedentary
Lightly Active
Moderately Active
Very Active
What types of exercise do you currently participate in?
Have you practiced yoga or Pilates before?
What are your fitness goals?
Flexibility
Strength
Stress reduction
Weight loss
Rehabilitation
Other:
What are your specific goals for yoga or pilates coaching?
(Please select all that apply)
Individual Coaching:
Private Yoga Sessions
Private Pilates Sessions
Personalized Yoga/Pilates Program
Rehabilitation-Focused Sessions
Prenatal/Postnatal Yoga/Pilates
Stress Reduction/Mindfulness Sessions
Group Coaching:
Group Yoga Classes
Group Pilates Classes
Beginner Yoga/Pilates Series
Intermediate/Advanced Yoga/Pilates Series
Specialized Workshops (e.g., Flexibility, Core Strength, etc.)
Corporate Wellness Programs
Online Coaching:
Live Online Private Sessions
Live Online Group Classes
Pre-recorded Video Library Access
Personalized Online Program Design
What days and times are you generally available for sessions?
What is your preferred method of communication?
Phone
Text
What are your expectations from this coaching experience?
Are you comfortable with hands-on adjustments (if applicable)?
Yes
No
Only with verbal consent
Are you comfortable with receiving feedback and corrections?
Yes
Yes, but gently
No
Do you have any concerns or questions about participating in yoga or Pilates?
I understand that yoga and Pilates involve physical activity and that there is a risk of injury.
I confirm that I have accurately represented my health and medical history.
I agree to inform my coach of any changes in my health or physical condition.
I understand that the coach is not a medical professional, and this coaching is not a substitute for medical advice.
I release the coach from any liability for injuries or damages that may occur during or as a result of participation in yoga or Pilates sessions, except in cases of gross negligence.
I consent to the use of my contact information for communication related to coaching services.
I understand that photos or video may be taken for promotional purposes and I consent to these being used.
I have read and understand this Client Intake Form.
Client Signature:
Client Intake Form Insights
Please remove this client intake form insights section before publishing.
Additional Notes for the Coach:
This comprehensive intake form should help you gather the necessary information to provide safe and effective yoga and Pilates coaching. Remember to adapt it to your specific coaching style and services.
Let's break down the Yoga & Pilates Coaching Client Intake Form section by section, providing detailed insights into its purpose and importance:
Section 1: Personal Information
Section 2: Health & Medical History
Section 3: Fitness & Exercise History
Section 4: Yoga & Pilates Coaching Services
Section 5: Client Suitability & Preferences
Section 6: Agreement & Consent
Overall Insights:
By carefully reviewing and analyzing the information gathered in this intake form, coaches can provide safe, effective, and personalized yoga and Pilates instruction.
Mandatory Questions Recommendation
Please remove this mandatory questions recommendation section before publishing.
That's a great question to ensure you're gathering the absolutely essential information! While all the questions are important for a comprehensive understanding, the mandatory ones are those critical for safety, basic communication, and establishing the coaching agreement. Here's a breakdown of the most crucial fields:
Absolutely Mandatory for Safety & Legal Reasons:
Highly Recommended and Practically Mandatory for Effective Coaching:
Why these are considered "mandatory":
While other questions provide valuable context and allow for more personalized coaching, the ones listed above are the absolute minimum you should collect before starting any sessions. You might consider marking these fields as required on a digital form or explicitly emphasizing their importance on a paper form.