Athlete Intake Form | Peak Performance Coaching

Personal Information

Tell us about you and how to reach you

Step 1 of 6

About You

Please provide the following details about yourself: Full name • Sport(s) you compete in • Years competing • Level of competition

Full Name (First & Last)* Please enter your full name.

Sport(s) Competed In* Please enter your sport(s).

Years Competing in Your Sport* Please select your years of experience.

Competition Level

Age

Position / Event / Role

Contact Information

Email Address* Please enter a valid email address.

Phone Number* Please enter your phone number.

Preferred Contact Method*

Email Phone Call Text

Step 1 of 6

Sport Background

Your athletic journey and current training environment

Step 2 of 6

Your Athletic Story

Briefly describe your athletic background and journey so far

Describe a recent competition or performance that stands out (positive or negative)

Training Environment

Team or Individual Sport?

Team Individual Both

Current Training Phase

Step 2 of 6

Mental Performance

Honestly assess where your mental game stands today

Step 3 of 6

Self-Rating (1–10)

Rate your current mental performance in each area: 1 = needs major work · 10 = elite level · Be honest — this reflects where you are right now

Mental Challenges

Which mental challenges do you currently experience? (select all that apply)

Describe your biggest mental performance challenge in your own words* Please describe your biggest mental performance challenge.

Step 3 of 6

Strengths & Vision

Where you excel and who you're becoming

Step 4 of 6

Mental Performance Strengths

What are your mental performance strengths?* Please describe your mental strengths.

Where do you most want to grow mentally?* Please describe where you want to grow.

Athlete Vision

What does your ideal version of yourself as a competitor look like? List 3–5 key characteristics:*

1

2

3

4

5

Step 4 of 6

Mindset Training

Your goals for this program and previous experience

Step 5 of 6

Mindset Performance Training

What made you choose to do Mindset Performance Training?* Please answer this question.

What do you hope to gain from this experience?

Previous Mental Performance Work

Have you worked with a sport psychologist, mental performance consultant, or done mental skills training before?

Yes No

Briefly describe your previous experience — what worked, what didn't

Step 5 of 6

Life & Schedule

Who you are beyond competition and when we can connect

Step 6 of 6

Life Outside Sport

What do you enjoy outside of sport? (hobbies, interests, activities)* Please answer this question.

What are your current time commitments?* Please answer this question.

Is there anything else you'd like us to know?

Scheduling & Availability

Preferred Days / Times

Session Format

Best Contact Method

All information provided is kept strictly confidential and used solely to support your mental performance coaching experience.