Whole Person Intake Form

Tool Should Be Used By:  Coaches who work with the whole person and is interested in such aspects of their clients as nutrition, fitness, relationships and other areas which may have impact on their total outlook and well being.

Tool Description: The whole person intake form is to be used by coaches and counselors to gain insight into their clients' needs. This 10-page form was created so that the coach or counselor initially has a greater sense to the whole person they are working with.

Areas of the form include:

  • self-assessment
  • personal goals
  • tastes and preferences
  • environment
  • spirituality
  • community
  • relationships
  • health and nutrition

This intake form is the first document often given to clients. Why not make it as comprehensive as possible?

As coaches and counselors we know that all aspects of the client are eventually discussed and all important in the movement of the process for the client. This 10 page form makes the task of inquiry around nutrition, fitness, spirituality, relationships and environment easy.

Each section of the intake form includes basic questions that give insight into the client and acts as a starting point for the coach or counselor's questioning.

The WPI form also asks the client for a self assessment as well as to review and state their own goals.

This 10 page WPI form is an invaluable tool for and practitioner for initial review of the client and their goals.

People who have worked with this document have said:

  • "I have used this form throughout my sessions with my clients. Not only does it give me basic logistical information but insight into the clients deeper thoughts"
  • "I never knew how to introduce nutrition into the conversation... now it is readily available"
  • "This form not only keeps my client sessions on track, but I can plan or strategize with my client, their direction of development as well as a call to action - each week!"

Ready to be printed out and filled out by the client, this form will save you a lot of time and give you a great deal of information about the client.

 Format:  PDF File (86KB)

Have a question? Contact seller directly at email

All rights reserved: May use with clients and prospects individually and reproduce for that purpose only. May not publish or re-sell in any form and must retain all copyright information.

Price:  $7.95 Add to Cart

Creator's BackgroundVivian Burns Lennan is a spiritual counselor, personal Fitness trainer, nutritional practitioner and a personal coach. She works with people on living life consciously. "Through an integrative inquiry we begin to awaken the mind, body and spirit in living an authentic, meaningful life." Vivian lives in NY state, is Leader of the Holistic coaching SIG and a co-leader of the virtual community of the ICF. She facilitates the Extreme Self Care Program, Girls Circle and Living a Perfect Life Program, and writes a Cornerstone news e-zine. Her web site is: http://www.cornerstonecoachingandcounseling.com 


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