Yoga & Pilates Coaching Client Intake Form

I. Personal Information

Full Name

Date of Birth

Gender

Address







Phone Number

Email

Emergency Contact

Full Name

Phone Number

Relationship

II. Health & Medical History

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)

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?

III. Fitness & Exercise History

What is your current level of physical activity?

What types of exercise do you currently participate in?

Have you practiced yoga or Pilates before?

What are your fitness goals?

What are your specific goals for yoga or pilates coaching?

IV. Yoga & Pilates Coaching Services

(Please select all that apply)


Individual Coaching:

Group Coaching:

Online Coaching:

V. Client Suitability & Preferences

What days and times are you generally available for sessions?

What is your preferred method of communication?

What are your expectations from this coaching experience?

Are you comfortable with hands-on adjustments (if applicable)?

Are you comfortable with receiving feedback and corrections?

Do you have any concerns or questions about participating in yoga or Pilates?

VI. Agreement & Consent

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:

  • Review the client's health history carefully.
  • If there are any concerns, consult with the client's physician or request a medical clearance.
  • Discuss the client's goals and expectations to ensure a good fit.
  • Clearly explain the terms and conditions of the coaching agreement.
  • Keep all information confidential.
  • Have a system to track client progress.

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

  • Purpose:
    Establishes basic client identification and contact details.
    Provides a means of reaching the client in case of emergencies or scheduling changes.
    Date of birth can be useful for age related modifications.
  • Importance:
    Essential for record-keeping and communication.
    Emergency contact information is crucial for safety.

Section 2: Health & Medical History

  • Purpose:
    Identifies any pre-existing conditions, injuries, or limitations that may affect the client's ability to participate in yoga or Pilates.
    Helps the coach understand the client's physical needs and tailor sessions accordingly.
    Highlights potential contraindications to certain exercises.
  • Importance:
    Prioritizes client safety.
    Reduces the risk of injury.
    Enables the coach to provide appropriate modifications and precautions.
    Pregnancy/Postpartum questions are vital for safe instruction.
  • Detailed Questions:
    The specific questions about back pain, joint pain, etc., are designed to pinpoint common issues that yoga and Pilates can address, but also to identify areas where caution is needed.
    "Cleared by a medical professional" is a key question, especially for clients with significant health concerns.

Section 3: Fitness & Exercise History

  • Purpose:
    Gauges the client's current fitness level and experience with exercise.
    Helps the coach understand the client's baseline and set realistic goals.
    Determines the client's familiarity with yoga and Pilates.
    Gathers information about the clients goals, and expectations.
  • Importance:
    Ensures that the coaching is appropriate for the client's abilities.
    Helps the coach create a personalized program.
    Helps to align the coaches and clients expectations.
  • Detailed Questions:
    "Current level of physical activity" provides a general overview.
    "Types of exercise" gives more specific information about the client's fitness habits.
    "Fitness goals" and "specific goals for yoga/Pilates" are crucial for aligning the coaching with the client's desired outcomes.

Section 4: Yoga & Pilates Coaching Services

  • Purpose:
    Clearly outlines the available coaching options.
    Allows the client to select the services that best meet their needs.
    Defines the scope of the coaching relationship.
  • Importance:
    Provides transparency and clarity about the services offered.
    Helps the coach manage their schedule and resources.
    Allows the client to know what services are available.
  • Detailed Options:
    The breakdown into individual, group, and online coaching provides flexibility.
    Specifying yoga styles and Pilates equipment allows for more targeted service selection.
    Offering workshops, and corporate wellness programs, broadens the coaches potential client base.

Section 5: Client Suitability & Preferences

  • Purpose:
    Gathers information about the client's availability, communication preferences, and expectations.
    Assesses the client's comfort level with hands-on adjustments and feedback.
    Identifies any remaining concerns or questions.
  • Importance:
    Facilitates effective communication and scheduling.
    Ensures that the coaching environment is comfortable and supportive.
    Addresses any potential issues or misunderstandings.
  • Detailed Questions:
    "Availability" and "communication preferences" streamline logistics.
    "Hands-on adjustments" and "feedback" questions address important aspects of the coaching dynamic.
    "Concerns or questions" provides an opportunity for the client to voice any reservations.

Section 6: Agreement & Consent

  • Purpose:
    Provides legal protection for the coach.
    Ensures that the client understands the risks and responsibilities associated with yoga and Pilates.
    Obtains the client's informed consent.
    Addresses photo and video usage.
  • Importance:
    Reduces the risk of liability.
    Promotes transparency and accountability.
    Establishes a clear understanding of the coaching agreement.
  • Key Elements:
    Assumption of risk: The client acknowledges the potential for injury.
    Release of liability: The client releases the coach from liability (except in cases of gross negligence).
    Confidentiality: The coach agrees to keep client information confidential.
    Photo/Video consent: gives the coach permission to use media for promotions.
    Client signature: confirms that the client has read and understood the agreement.

Overall Insights:

  • This intake form is designed to be comprehensive and thorough.
  • It balances the need for detailed information with the goal of creating a welcoming and supportive environment.
  • It emphasizes client safety, communication, and informed consent.
  • It provides a solid foundation for a successful coaching relationship.
  • It is very important that coaches keep all client information secure and confidential.

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:

  • Full Name: Essential for identifying the client.
  • Date of Birth: Can be relevant for age-related considerations and liability.
  • Emergency Contact Name & Phone: Crucial in case of an emergency during a session.
  • Please list any current medical conditions or injuries: Directly impacts safety and the ability to participate.
  • Are you currently taking any medications? If yes, please list: Can interact with physical activity.
  • Do you have any allergies? If yes, please list: Important for the environment and any potential reactions.
  • Have you been cleared by a medical professional for physical activity? (If applicable, please provide details): Especially important if the client has known health issues.
  • Client Signature & Date: Legally binding part of the agreement and consent.

Highly Recommended and Practically Mandatory for Effective Coaching:

  • Phone Number & Email Address: Necessary for scheduling, communication, and sending important information.
  • What are your fitness goals? Helps tailor the coaching to the client's desires.
  • What are your specific goals for yoga or Pilates coaching? Provides more focused direction for the sessions.
  • Agreement & Consent statements (leading to the signature): Ensures the client understands the risks and the terms of service.

Why these are considered "mandatory":

  • Safety First: The medical history and emergency contact information are paramount for the client's well-being during sessions.
  • Legal Protection: The agreement and signature protect both you and the client by establishing informed consent and understanding of risks.
  • Basic Communication: Without contact information, you can't effectively schedule or communicate with your client.
  • Understanding Goals: Knowing the client's goals is fundamental to providing relevant and effective coaching.

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.


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