Get Wa Resilient Spirit Wellness Client Intake Form 2017-2025

Completing the WA Resilient Spirit Wellness Client Intake Form is an essential step before your meeting with the Holistic Nutrition and Wellness Coach. This form gathers vital information about you, your health goals, and your wellness journey.

Follow the steps to fill out the form accurately and effectively.

1. Click the ‘Get Form’ button to access the intake form and open it in your preferred document editor.
2. Begin filling in your client information, which includes your name, date, address, phone numbers, email, occupation, family or living situation, and names and ages of children, if applicable.
3. In the health information section, provide your date of birth, age, identified gender, height, current weight, ideal weight, and weight from one year ago. Additionally, describe your body type and rate your general health and satisfaction with your body from 1 (poor) to 10 (excellent).
4. Indicate your smoking and alcohol consumption habits, including exercise type and frequency, sleep hours, daily water intake, and feelings of happiness. Note any family health history, personal health concerns, bowel movement frequency, intestinal discomfort, and share any other relevant health information.
5. Move to the lifestyle history section, where you will detail any recent major life changes, vacation time taken from work, methods of handling stress, exposure to toxins, and describe two significant changes you wish to make in your life or health within the next three months.
6. Identify three areas that you find most important from the provided list. Rate your satisfaction with your physical activity on a scale of 1 to 10, categorize your activity level, and explain your physical activity over the past year.
7. In the nutritional and diet history section, describe any special diets you follow, foods you avoid, symptoms after eating, typical meal compositions, and your relationship with food. Provide details about your cooking habits and the types of snacks and favorite foods you enjoy.
8. Finally, in the other information section, discuss the support system from friends and family, detail your main health goals, what success looks like for you in terms of eating and exercise, and assess your motivation to change your current habits.
9. Once you have completed the form, review your entries for accuracy and clarity. You can save your changes, download, print, or share the form with your wellness coach to complete the process.

Take the time to complete the WA Resilient Spirit Wellness Client Intake Form online and embark on your wellness journey today.