Coaching Agreement Template for Fitness for Back Pain

Use in FirstRep document

Client Information

Collecting accurate client information is crucial for tailoring the coaching program for back pain.

Aa Name *

Enter your full name

Aa Email *

Enter your email address

Aa Phone Number *

Enter your phone number

# Age *

Enter your age

Medical History

Understanding the client’s medical history is vital for developing a safe exercise plan.

Y/N Do you have a history of back pain? *

Y/N Have you undergone any surgeries? *

... Please list any medical conditions:

List your medical conditions

... Current Medications

List any medications you are currently taking

Physical Activity Level

Assessing the client's current activity level helps tailor the exercise program effectively.

v Current Activity Level *

Select your activity level

... What types of exercise do you currently do?

Describe your current exercises

1-10 How often do you experience back pain during activities? *

Rate from 1 (never) to 10 (always)

Goals and Expectations

Clarifying client goals helps in setting realistic outcomes and expectations.

... What are your primary goals? *

List your fitness goals related to back pain

... What are your expectations from this coaching? *

Describe your expectations

Exercise Agreement

This section outlines the agreement on exercise participation and safety.

Y/N I agree to consult a physician before starting any exercise program. *

Y/N I understand the risks involved in physical activity. *

Referral Information

Knowing when to refer clients to other practitioners is important for their health.

Y/N Do you have a current physical therapist?

... If yes, please provide their contact information:

Physical therapist's contact

Why Use This Template

Customized Approach

Tailors the coaching experience to each client's unique back pain issues.

Safety First

Ensures clients are aware of the risks and have medical clearance.

How to Use

Download the template and fill in the necessary client information.

Review the medical history to identify any red flags before starting the program.

Customization Tips

Adjust the fields to better suit your coaching style or client needs.
Add specific exercises or recommendations based on your expertise.
Include a section for client feedback after each session.

Build and send fitness for back pain templates digitally with FirstRep. Free for up to 3 clients.

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Frequently Asked Questions

What should I do if I experience pain during exercises?

Stop immediately and consult with your healthcare provider if the pain persists.

How long will it take to see improvements?

Every client is different; however, consistent effort typically shows results within a few weeks.