What is the wellness coaching intake form template?
A first coaching session goes further when the coach already knows the basics: what the client wants to work on, how they're sleeping and coping with stress, what they've tried before and how ready they feel. Without an intake, the first hour is spent gathering facts instead of coaching.
This template collects those facts over three pages. Clients choose up to three priorities and say why now, rate seven areas of their life in a grid, describe sleep, stress, energy, activity and eating, and flag any health conditions. They finish with a three-month goal, their readiness to change, the coaching style that helps them and how often they'd like to meet.
Each intake is filed as a PDF in your FileIt vault, so you can reread it before sessions and compare later check-ins against where the client started.
- Best for
- Health and wellness coaches, life coaches and corporate wellbeing programmes
- Filled in by
- New coaching clients before their first session
- Time to complete
- About 10 minutes
- Includes
- Priorities, wellbeing grid, sleep and stress scales, health notes, goal and readiness questions, coaching preferences and agreement
Who uses a wellness coaching intake form?
- An independent health coach sending the intake after a discovery call
- A corporate wellbeing programme onboarding employees to one-to-one coaching
- A gym adding wellness coaching alongside personal training
- A coach running group programmes who wants each member's starting point
- A practice where several coaches share one intake format
Questions on this wellness coaching intake form
28 questions over 3 pages · includes conditional questions, multiple pages, consent checkbox, ratings.
1 About you
- Your name*
- Email*
- Phone
- Time zone or city
- What do you do day to day?
- What would you most like to work on?* Eating habits · Movement and exercise · Sleep · Stress · Energy · Weight · Work-life balance · Confidence and mindset · Habits like smoking or alcohol · Managing a health condition
- Why now? What made you look for a coach?*
2 Where you are now
- How are these areas for you at the moment?* Poor · Fair · Good · Great
- Hours of sleep on a typical night Less than 5 · 5-6 · 6-7 · 7-8 · More than 8
- How rested do you usually feel when you wake up?
- Your stress level over the last two weeks*
- Main sources of stress asked only when it applies Work · Money · Family or caring · Health · Relationships · Housing · Studies
- When does your energy dip? Morning · Mid-afternoon · Evening · All day · It's fairly steady
- How active are you in a typical week? Mostly sitting · Some walking or light activity · Exercise 1-2 times · Exercise 3 or more times
- Describe a typical day of eating and drinking
- Do you have any health conditions, or are you under a doctor's care for anything?*
- Anything you'd like your coach to know asked only when it applies
- Has a doctor advised you to avoid any activity or diet change? asked only when it applies
3 Goals & coaching style
- If coaching goes well, what will be different in three months?*
- What have you tried before, and what got in the way?
- How ready do you feel to make changes right now?*
- Do the people around you support the changes you want to make? Yes · Somewhat · Not really · I haven't told them
- What helps you most from a coach? Gentle encouragement · Direct challenge · Clear plans and actions · Space to talk things through · Education and information · Regular check-ins between sessions
- Preferred session format* Video call · Phone · In person · No preference
- How often would you like to meet? Weekly · Every two weeks · Monthly · Not sure
- How would you like check-ins between sessions? Email · Text or messaging app · No check-ins, thanks
- Best days and times for sessions
- Coaching agreement*
The wellness coaching intake form, page by page
1 About you
Clients give their name, email, phone, time zone and a line about their day-to-day work. "What would you most like to work on?" allows up to three priorities — eating, movement, sleep, stress, energy, weight, work-life balance, mindset, habits like smoking or alcohol, or managing a health condition — and "Why now? What made you look for a coach?" is required.
2 Where you are now
A grid rates eating, movement, sleep, stress, energy, relationships and work from poor to great. Clients give their usual hours of sleep and how rested they feel, then rate their stress over the last two weeks on a 1-10 scale — a score above 6 asks for the main sources. Questions on energy dips, activity and a typical day of eating follow.
"Do you have any health conditions, or are you under a doctor's care for anything?" is required, with help text noting coaching doesn't replace medical care. A yes opens a notes box and asks whether a doctor has advised against any activity or diet change.
3 Goals & coaching style
Clients describe what will be different in three months if coaching goes well, what they've tried before, and rate how ready they feel to change. They say whether the people around them are supportive, what helps them most from a coach, their preferred session format, frequency and check-in method, and the best times for sessions. A coaching agreement confirms coaching isn't medical or psychological treatment.
Make the template yours
- Edit the priority list to match your coaching niche, such as menopause, burnout or diabetes prevention
- Add your packages and fees as a question on the last page
- Replace the coaching agreement with your own terms and cancellation policy
- Raise or lower the stress score that shows the sources question
- Send a shorter version of the same form as a monthly check-in
- File each client's intake into their own folder in your vault
Tips for a better wellness coaching intake form
- Read the readiness score before the first session — low readiness changes where you start
- Use the client's own three-month goal in their words when you review progress
- Refer on when health answers suggest something outside coaching's scope
- Keep the intake to one sitting so clients don't abandon it halfway
- Repeat the wellbeing grid after a few months to show change
Every response becomes a PDF in your vault
When a client submits the intake, FileIt files it as a PDF in your vault and emails you. The client can receive a copy of their answers for their own reference.
Every intake also sits in the Responses table, where you can open it, filter by priority or format, and export answers to a CSV.
- Start from this template. It opens in the FileIt Forms designer — change any question, add pages, set the rules for when questions appear.
- Share it. Turn on a public link, or send it to people by email, each with their own link. They don’t need a FileIt account.
- Get the answers as PDFs. Each response is saved as a PDF in the vault folder you choose, with uploaded files attached — and listed in a Responses table you can export to CSV.
Wellness coaching intake form: frequently asked questions
Is this wellness coaching intake template free?
Yes. It's included with FileIt Forms on every plan, and every question can be changed.
Do clients need a FileIt account?
No. They open a link and fill it in on any device.
Is this a medical questionnaire?
No. It asks about health only so the coach knows what matters for coaching, and the agreement makes clear coaching isn't treatment. Use a clinical intake if you're a licensed practitioner.
Can I use it for life coaching rather than health?
Yes. Edit the priorities and the wellbeing grid — the goals, readiness and coaching-style questions work for any coaching.
Can I send it to each client personally?
Yes. Email personal links with the client's name and email filled in, instead of a public link.
How do I track progress later?
Duplicate the form as a shorter check-in with the same grid and scales, and compare the PDFs or the CSV export over time.