
Date
Company Name
Company Address
City
State
Zip Code
Contact Person
Job Title
Phone Number
Email Address
Website
Industry
Number of Employees
What are your primary goals for implementing an on-site fitness program? (Check all that apply)
Improve employee health and well-being
Increase employee morale and engagement
Reduce absenteeism and sick leave
Enhance team building and collaboration
Boost productivity and focus
Attract and retain talent
Other (Please specify):
What specific metrics or outcomes would you like to track to measure the program's success?
What is your desired timeframe for implementing the program?
As soon as possible
Within 1-3 months
Within 3-6 months
Other (Please specify):
What is your budget range for this program?
Under $1,000.00 per month
$1,000.00−$2,000.00 per month
$2,000.00−$5,000.00 per month
$5,000.00+ per month
Other (Please specify):
What frequency of classes are you considering?
Once a week
Twice a week
Three times a week
Daily
Other (Please specify):
What is your desired class duration?
30 minutes
45 minutes
60 minutes
Other (Please specify):
What is the general age range of your employees?
18-25
26-35
36-45
46-55
56+
Other (Please specify):
What is the approximate gender distribution of your employees?
Predominantly Male
Predominantly Female
Balanced
What is the general fitness level of your employees?
Mostly sedentary
Mixed (some active, some sedentary)
Mostly active
Are there any specific health concerns or physical limitations we should be aware of?
What times of day are most convenient for employees to participate in fitness classes?
Morning (before work)
Lunchtime
Afternoon (after work)
Flexible
Other (Please specify):
What type of fitness classes are your employees likely to be most interested in? (Rate on a scale of 1-5, 1 being "Not Interested" and 5 being "Very Interested")
Yoga:
Pilates:
Strength Training:
Cardio/HIIT:
Zumba/Dance Fitness:
Mindfulness/Meditation:
Flexibility/Mobility:
Team-Based Fitness:
Do you have an existing space that can be used for fitness classes?
What is the approximate size of the available space? (Square feet/meters)
Are there any existing fitness equipment or amenities available?
Are there changing rooms and shower facilities available?
Are there any restrictions or limitations regarding noise levels or space usage?
Are there any existing wellness initiatives or programs in place?
How did you hear about our on-site fitness programs?
Is there any other information you would like to provide?
Thank you for completing this form. We will review your information and contact you to schedule a consultation.
Form Template Insight
Please remove this form template insight section before publishing.
Important Notes:
By using this detailed intake form, you'll be well-equipped to understand your clients' needs and create a successful on-site fitness program.
Let's break down the client intake form and delve into the detailed insights it provides, section by section:
1. Company Information:
Purpose: This section establishes the basic identity of the client. It's crucial for contact, record-keeping, and understanding the client's industry context.
Insights:
2. Program Goals & Objectives:
Purpose: This is the core of the form. It reveals the client's motivations and desired outcomes, guiding program design and evaluation.
Insights:
Primary Goals:
Metrics/Outcomes:
Timeframe and Budget:
Frequency and Duration:
3. Employee Demographics & Preferences:
Purpose: This section focuses on the target audience – the employees. It gathers information to ensure program relevance and accessibility.
Insights:
Age Range and Gender Distribution:
Fitness Level and Health Concerns:
Preferred Times and Class Types:
Rating scale for class types:
4. Facility & Equipment:
Purpose: This section assesses the physical environment and resources available for the program.
Insights:
Available Space and Equipment:
Amenities and Restrictions:
5. Additional Information:
Purpose: This section gathers supplementary information and provides an opportunity for open-ended communication.
Insights:
Existing Wellness Initiatives:
How They Heard About You:
Open-Ended Questions:
6. Program Suitability Questions (Consultation Focus):
Purpose: This section guides the consultation process and ensures a personalized approach.
Insights:
Accessibility and Engagement:
Tailoring and Accommodation:
Practical Considerations:
Integration and Alignment:
Inclusivity:
Overall Insights: