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Sample Client Intake Form

The document provides guidelines for nutritional coaches on conducting an initial client intake consultation. It outlines three key frameworks coaches should use: [1] establishing a personal connection, [2] understanding the client's "why" or motivation, and [3] establishing a vision and nutrition plan. The intake should gather information in 10 sections, including goals, medical history, diet and lifestyle. Coaches are reminded to focus first on foundational topics, ask questions to go deeper, and use tools to help clients learn and achieve meaningful results through the coaching process.

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Bay Tucek
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52 views5 pages

Sample Client Intake Form

The document provides guidelines for nutritional coaches on conducting an initial client intake consultation. It outlines three key frameworks coaches should use: [1] establishing a personal connection, [2] understanding the client's "why" or motivation, and [3] establishing a vision and nutrition plan. The intake should gather information in 10 sections, including goals, medical history, diet and lifestyle. Coaches are reminded to focus first on foundational topics, ask questions to go deeper, and use tools to help clients learn and achieve meaningful results through the coaching process.

Uploaded by

Bay Tucek
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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The Nutritional Coaching Institute

CLIENT INTAKE

Property of The Nutritional Coaching Institute


Copyright 2023
THE FIRST CONVERSATION

- Rule #1 as a coach, is that you owe it to your new client to TELL THE TRUTH!!
- As much as our hearts and passion want to fulfill your new clients expectations,
you must remember that you were chosen to give them results they did not
believe they could achieve.
- Give your clients what they NEED, not what they WANT.

This first contact is your opportunity to earn your clients trust, confidence and belief in
the process, in you and in themselves.

In this intake consultation you will be going through 3 frameworks using our NCI tools
you have learned in our Level 1 Course.

1. Establish a personal connection.


- Finding things in common, having easy talk in the first 5-15 minutes can
determine if they are going to stay with you for 6 months or 6 minutes)
- NCIs Connection-Based Model of coaching

2. Dig deep to find their “WHY”.


- This part is important because this is how we help our clients LEARN and
Understand why they are doing what they are doing.
- This all starts with our (triangle of awareness)

3. Establishing the Vision


- (using the Nutrition Periodization Model)
- Show them what is to be expected in the journey. Its pretty difficult to
navigate new areas without a map. This is your clients map to their
results. They want to know where they are at, and what is coming up next.

THE INTAKE / CONSULT

This process should be your guideline and opportunity to gather as much


information as possible.
Remember lets cover the foundational basics first before you take your clients through a
confusing rabbit hole of hormones and gut health.

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The intake should be easy to complete.
- If you are sending it to them, keep it under 10 minutes. The longer it takes thes
less likely you will have true deep answers or completed within an adequate time
frame.
- If you are conducting the intake in person, or video call then you have the
opportunity to make it a bit longer with a chance to ask more questions and dive
deeper into their answers.

10 GENERAL SECTIONS:
1. Age / Height / Weight
- This is data that will become helpful for establishing caloric intake
and starting points.

2. Daily Schedule and Activity


- Get an idea of what a day in the life of your client looks like.
- When they wake up, when they train, when they work, when they
eat and when they go to sleep.
- This can also give you a glimpse of any red flag stressors
- What do they do for a living
- What part of the day do they feel tired/ lethargic.

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3. Current Workout Routine
- Time of day
- Frequency, intensity, duration, as well as what type of training and
why?
- Are they training for the wrong reason, or is their training creating
more stressful harm than good.

4. Injury History/ Surgeries


- This is where you can get a slight insight into any medical conditions
or injuries that may need to be known for any training adjustments.

5. Current Supplementation / Medications


- You will be surprised as to how many supplements your client is
taking and many times they dont know how it is actually helping
them.
- These may also not be aligned with their goals.
- Understanding their medication intake is very important, so that any
type of food recalls can be assessed by medication interactions.

6. Dieting History
- What have they tried.
- What worked
- What did not work
- Why did they stop
- What did they like and dislike about…
- Learn what direction you can and should not take.

7. Food Preferences and Allergies


- A great way to make sure you are not making recommendations on
food that may cause unwanted reactions.

8. Food Recall
- You can actually take this in a few different directions.
- List of their most commonly eaten foods
- A recall of their most recent food intake the day before or current
day.

9. Detailed Goal(s)
- Introduce and discuss the triangle of awareness in this part.
- Go deep into their goals and always ask “WHY”

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- A good coach does not accept a simple answer of being fit and
healthy. A great coach will find that moment within their client that
explains why its so important to them that they work on themselves.

10. Photos and Measurements


- Photos do not have to always be the standard (front, side and back)
profiles although those are the best.
- Keep your clients comfortable and maybe even just allow them to
use a full body photo of themselves where they are not feeling,
looking their best.
- Measurements can be as simple as hip, waist and chest, but you can
have them also take arm, thigh and calf measurements as well.

* Here is an example of a client intake with links for you. Please feel free to copy
and add it to your drive to brand it as your own.

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