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Health Coach Intake Form for the United Kingdom

Health Coach Intake Form Template for England and Wales

A Health Coach Intake Form Template is a comprehensive document used in England and Wales for gathering essential information about new clients seeking health coaching services. It complies with UK GDPR and healthcare regulations while collecting medical history, lifestyle information, and personal goals. The form serves as both a diagnostic tool and a legal record, ensuring proper client assessment and protection of sensitive health information.

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What is a Health Coach Intake Form?

The Health Coach Intake Form Template is designed for use in England and Wales by health and wellness professionals to collect and document client information at the start of a coaching relationship. This document ensures compliance with UK data protection laws while gathering essential health, lifestyle, and goal-related information. It serves as a foundation for creating personalized coaching plans and maintaining accurate records of client history and objectives. The form is particularly crucial for establishing clear communication channels and understanding client needs while maintaining professional standards and legal requirements.

What sections should be included in a Health Coach Intake Form?

1. Personal Information: Basic contact details, emergency contacts, and demographic information required for client identification and communication

2. Medical History: Current and past health conditions, medications, treatments, surgeries, and allergies

3. Lifestyle Assessment: Comprehensive overview of diet, exercise, sleep patterns, stress management, and daily habits

4. Goals and Expectations: Client's specific health and wellness objectives, timeframes, and desired outcomes

5. Privacy Notice: GDPR-compliant data protection and confidentiality statements, including how personal information will be used and stored

What sections are optional to include in a Health Coach Intake Form?

1. Nutritional Assessment: Detailed dietary preferences, restrictions, supplements, and eating patterns for nutrition-focused coaching

2. Physical Activity History: Comprehensive exercise history, fitness level assessment, and physical activity preferences for fitness-focused coaching

3. Mental Health Assessment: Evaluation of stress levels, anxiety, depression, and other mental health factors for holistic wellness coaching

What schedules should be included in a Health Coach Intake Form?

1. Terms and Conditions: Detailed service terms, cancellation policies, liability limitations, and legal disclaimers

2. Consent Forms: Medical information sharing authorization and coaching program participation consent documents

3. Health Metrics Tracking Sheet: Standardized template for monitoring progress and key health indicators throughout the coaching program

Authors

Alex Denne

Head of Growth (Open Source Law) @ Ƶ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Jurisdiction

England and Wales

Publisher

Ƶ

Document Type

Intake Form

Cost

Free to use
Relevant legal definitions

























Clauses

























Industries

UK GDPR and Data Protection Act 2018: Core legislation governing how personal and sensitive health data must be collected, processed, stored and protected. Requires explicit consent for data processing and details of data usage.

Privacy and Electronic Communications Regulations (PECR): Regulations governing electronic communications and the protection of privacy in digital communications between health coach and client.

Health and Social Care Act 2012: Framework legislation for health services in England, setting standards for health service providers including private practitioners.

Care Standards Act 2000: Establishes standards of care and service provision in healthcare settings, relevant for setting professional service standards.

Consumer Rights Act 2015: Defines consumer rights and business obligations, ensuring transparency and fairness in service contracts and terms.

Consumer Protection from Unfair Trading Regulations 2008: Protects clients from unfair practices and ensures transparent communication about services and qualifications.

Access to Health Records Act 1990: Governs access to health records and medical information, including client rights to access their own records.

Health Records Act (Wales) 2001: Specific Welsh legislation regarding the handling and maintenance of health records.

Equality Act 2010: Ensures non-discrimination and equal access to services, requiring reasonable adjustments for disabled clients.

Unfair Contract Terms Act 1977: Regulates contractual terms to ensure fairness and prevents unreasonable limitations of liability.

Common Law Duty of Confidentiality: Legal obligation to maintain client confidentiality and protect sensitive personal information shared during coaching sessions.

NHS Confidentiality Code of Practice: Guidelines for handling confidential health information, relevant even for private practice to maintain professional standards.

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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