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Menopause & Women’s Health Coaching Intake Form

Menopause & Women’s Health Coaching Intake Form

Support women through menopause with tailored coaching, capturing their symptoms, stage, goals, and health in one form.

Description

The Menopause and Women’s Health Coaching Intake Form gives coaches a warm, understanding way to onboard clients. It invites them to share what they are noticing most, where they are in the journey, and what they would most like to feel or achieve, so support is centered on the individual.

Fields for their goals, any health conditions or medications, activity levels, and how their stress and sleep are build a full picture, while a question about whether they are working with a doctor keeps care joined up. Capturing all this with care means genuinely tailored coaching.

The right support changes how women experience menopause. Sign up for a free Fun Forms account to customize the fields and embed this intake form on your website.

Form fields

Everything the Menopause & Women’s Health Coaching Intake Form above collects — 13 fields across 3 pages, so you can see exactly what it captures before you make it your own.

Thrive Through Menopause

What are you noticing most?
Multi-Select
Where are you in the journey?
Dropdown
What would you most like to feel or achieve?
Long Answer
What are your goals?
Multi-Select

Health & Lifestyle

Any health conditions or medications we should know about?
Long Answer
How active are you right now?
Dropdown
How's your stress and sleep?
Dropdown
Are you working with a doctor on this?
Yes/No

Your Details

Your name
Name
Email address
Email
Phone number
Telephone
Age
Number
Confirmation
Consent

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Template FAQs

Common questions about the Menopause & Women’s Health Coaching Intake Form — what it captures, when to use it, and how to make it your own.

What is a menopause and women’s health coaching intake form?

A menopause and women’s health coaching intake form is an online form used to onboard clients navigating menopause. It captures their symptoms, stage, goals, and health, so a coach can offer tailored, understanding support centered on the individual.

Why ask where a client is in the journey?

Symptoms and needs vary greatly across perimenopause, menopause, and beyond, so knowing where a client is helps you support them appropriately. It lets you tailor guidance to their stage and respond with understanding to what they are likely experiencing right now.

Why ask about stress and sleep?

Menopause often affects stress, sleep, energy, and mood, which in turn shape wellbeing and how the body responds to exercise. Capturing them gives a fuller picture, so you can support the whole person and address the lifestyle factors that matter most during this time.

Why ask if a client is working with a doctor?

Knowing whether a client is working with a doctor helps you keep support joined up and within your scope. It lets you complement their medical care rather than duplicate or contradict it, so the client receives coherent, appropriate support across everyone helping them.

Why ask what a client most wants to feel or achieve?

Asking what a client most wants to feel or achieve centers the coaching on what matters to them, whether more energy, strength, or confidence. It makes support personal and motivating, so the client feels genuinely heard and understood throughout their journey.

Is the menopause and women’s health coaching intake form free?

Yes, this menopause and women’s health coaching intake form is completely free, and you can customize the fields to fit your coaching, embed it on your website, and go live with no coding required. Just create a free Fun Forms account to start supporting clients online.

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