Client Intake Form Template for Fitness for Stress Management

Use in FirstRep form

Personal Information

Collecting personal information helps us tailor a fitness plan that meets your unique needs.

Aa Full Name *

Enter your full name

Aa Email Address *

[email protected]

# Age *

Your age

Aa Occupation *

Your job title

Stress Levels

Understanding your stress levels can guide us in creating a balanced approach to fitness.

1-10 Current Stress Level *

Rate your stress from 1 (low) to 10 (high)

... Primary Sources of Stress *

Describe your main stressors

Exercise History

Your previous experience with exercise helps us understand what works best for you.

v Previous Exercise Frequency *

vv Types of Exercise Enjoyed *

Y/N Any Previous Injuries? *

Have you had any injuries?

Mental Health Support

Integrating mental health support is crucial for a holistic approach to fitness.

... Current Mental Health Status *

Briefly describe your mental health condition

vv Current Support Systems

Goals and Expectations

Identifying your goals helps us create a focused and effective fitness plan.

Aa Primary Fitness Goal *

What do you hope to achieve?

... Expected Outcome *

Describe what success looks like for you

Exercise Intensity Preferences

Understanding your preferences regarding exercise intensity is vital to avoid overtraining.

v Preferred Exercise Intensity *

Y/N Willingness to Try New Activities *

Are you open to trying new forms of exercise?

Why Use This Template

Focus on Mental Health

This form emphasizes the integration of mental health support with fitness.

Tailored Approach

Personalized data allows for customized fitness plans that consider stress levels.

How to Use

Fill out all sections completely to ensure a comprehensive assessment.

Return the form via email or in person to start your journey.

Customization Tips

Adjust the questions based on specific client needs.
Include additional fields for unique stressors or goals.
Modify the format to suit your practice style.

Build and send fitness for stress management templates digitally with FirstRep. Free for up to 3 clients.

Start for Free See All Features

Frequently Asked Questions

How long will it take to complete this form?

The form should take about 10-15 minutes to complete thoroughly.

Will my information be kept confidential?

Yes, your information will be kept private and used solely for your fitness plan.