Mental Training Intake Form
Please complete this intake form to help us understand your mental training needs and goals.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Age
*
What is your primary sport or performance area?
*
How many years of experience do you have in your sport or performance area?
*
Please Select
Less than 1 year
1-3 years
4-7 years
8-10 years
More than 10 years
Have you previously worked with a mental coach or participated in mental training?
*
Yes
No
What are your main goals or areas you wish to improve through mental training? (e.g., focus, confidence, stress management, motivation)
*
Please rate your current mental skills in the following areas:
*
Rows
Focus
Confidence
Stress Management
Motivation
Goal Setting
Very Weak
1
2
3
4
5
Weak
6
7
8
9
10
Average
11
12
13
14
15
Strong
16
17
18
19
20
Very Strong
21
22
23
24
25
How motivated are you to participate in mental training at this time?
*
Not motivated
1
2
3
4
5
6
7
8
9
Extremely motivated
10
1 is Not motivated, 10 is Extremely motivated
What days/times are generally best for you to schedule mental training sessions?
Is there anything else you would like your mental coach to know?
Submit Intake Form
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