A successful intake process is essential to truly create a successful, INDIVIDUALIZED program. While an intake form is nothing new, maximizing your interpretation skills can truly make you a better coach.
In this chapter we will review what we believe to be the essential components of an intake form and what you should expect to learn from them.
We have labeled each piece with a “why” and a “takeaway” for you. The “why” will explain why you need this data and the “takeaway” will help you read beyond the written word, and to truly understand your client and what lifestyle factors can potentially increase the application of your protocol.
Why – These are the three data points needed to determine BMR using the Harris Benedict Equation.
Takeaway – While this data is relatively straight forward, you will often get clients that report a “current weight” along with previous weights (high or low) – having this history can be helpful, but can also indicate that a client does not really accept their current reality or the results of their choices. This is something to have in mind as you begin your journey with the client.
Food Recall (3-7 days)
Why – Having an initial baseline intake is essential to proper prescription. While there are several formulas (previously listed in this text) for determining caloric needs of a client, they do NOT take into account current intake. This can be disastrous in terms of results, especially in cases of metabolic adaptation. Conversely, if the client has an excessive deficit, cutting too many calories simply because a formulas says so is also inefficient.
This is also an opportunity to look at any issues with food quality. A presence of an excessive amount of refined foods definitely needs to be addressed.
Finally, take a look at the amount of food that is home prepared vs eaten out. This can be a great topic of conversation and can lead you to providing the proper help from day 1.
Takeaway – Once again, this is relatively straight forward, but there are a few pieces of insight to be gained. First would be the number of days provided. As noted, three to seven days is preferred and requested but not always provided.
A client that jumps the gun and only provides one day can be a red flag. While not always the case, this can be an indicator that the client is heavily reliant on you to have a “magic fix,” which we know can be a recipe for disaster.
A client that is thorough in this piece of the intake tends to be a compliant client, which is great for you as you begin your working relationship.
A client that refuses to track is a major red flag and needs to be addressed before moving forward.
Current Workout Routine
Why – Understanding the overall volume and intensity of a client’s training protocol is an essential factor to determining their Total Daily Energy Expenditure. This is also a good time to see if a client is using a properly periodized approach or if they are overworking themselves and creating a stimulus of overtraining.
Your goal should be to determine which energy systems primarily need to be fueled and the degree of recovery required for the intensity of the program, as well as the overall fuel requirements based on the individual’s goals.
Takeaway – You will typically see two types of replies to this question:
- a full detailed training protocol
- a quick “I go to the gym 5 days a week and lift and do cardio” type answer
Similar to the “food recall” section above, the detail with which a client provides this answer can give a great insight into the client’s current mindset. When a client takes the time to fill you in on all of the details of their training plan it is typically a sign that they are detail oriented and are likely giving a maximal effort during their time in the gym.
A client that gives the second answer is typically inconsistent with training and the effort given when they do get to the gym is likely not maximal. This is NOT ALWAYS a bad thing, but it does need to be understood as training intensity is a part of understanding TDEE.
This portion of the intake may lead to further questions around periodization so don’t be afraid to ask more questions if you feel them to be appropriate.
Diets You have tried (with or without success)
Why – This question will give great insight into the metabolic history of the client. As you will learn later, caloric prescription is not always about simply understanding TDEE and creating a deficit/surplus – it is also about understanding the client’s current metabolic health and adjusting accordingly.
You can also learn a client’s dieting preferences here. Some clients may love a lower carb approach while others despise it. As we know, each application can yield success so keeping a client close to their comfort zone (especially in the initial phase) can be very beneficial when beginning a working relationship.
Takeaway – This section is very important. Understanding metabolic health (combined with TDEE) will be an integral factor in determining caloric prescription.
Most importantly, this is your opportunity to learn if a client has ever followed through on a program. This will allow you to begin a conversation around WHY they stopped and started the other dietary protocols and will allow you to ensure you help them avoid those pitfalls moving forward. As we know it is rarely the protocol itself that is not effective, it’s the implementation that is lacking.
If you see a client that rapidly changes protocols, this is a major red flag. This is likely due to a search for “quick results” which you know you will not be providing. Before you move into your work with this client be sure to have this conversation first and to set your expectations for your work with them.
Daily Schedule and Daily Activity
Why – There are two components here that you are looking for. The first is to address “critical times of feeding” within the prescription. As you will learn later in this text, helping a client understand pre and post workout nutrition can go a long way in terms of maximizing performance and recovery.
The second is to better understand the physical nature of the client’s day away from training – or their levels of NEAT (explained earlier in this text.) As discussed previously, NEAT can play a large role in the TDEE equation. It can also help guide macronutrient composition requirements based on the stress response of the activity.
Finally, this is an opportunity to begin addressing factors like sleep that can contribute (positively or negatively) to recovery.
Takeaway – Many clients do not understand the correlation of stress response and their goals. This question allows you to begin the conversation to address this. Helping a client understand that their lack of sleep or extremely stressful job has a major impact on their results will help them establish awareness in their day to day living.
Once again, the depth to which this question is answered will give you a deeper insight into the client’s mindset. A detailed, well explained answer is typically indicative of a client that is organized and will not struggle making a transition into their new protocol. Conversely, an answer that is brief and/or lacks clarity (i.e. “busy schedule, I travel a lot”) can indicate blame shifting or that a client is not taking responsibility for their current actions. This will need to be addressed in the initial conversation.
Why – This is very straight-forward and is simply data. Having a baseline as to what the client is currently using is very important when viewing a client’s current deficiencies and/or areas of success.
Takeaway – While the topic of supplements is very straight forward, we typically see three different kinds of responses here
- nothing (or very little) is used
- a few vitamins/minerals and/or basic supplements are used
- everything under the sun is being used
The first situation is relatively common and is typically an indicator that a client is just uneducated and/or fearful of the subject. This indicates your need as a coach to educate as you prescribe.
The second situation indicates that the client has some education around this topic and that they believe they are addressing specific needs. This could be secondhand information that they are getting from their friends or trainers, but it usually comes as some form of an informed decision. Typically this is a good thing as they are open to maximizing their results by doing everything necessary.
The final situation can be a major red flag. Far too many people view supplements as a “cure” to their deficiencies. Instead of addressing their lifestyle and/ or diet, they supplement. This leads to a laundry list of pills and powders, most of which have very little peer reviewed support for efficacy. This can indicate that a client is always looking to find a way around making proper choices, which will absolutely need to be addressed and monitored in your working relationship.
Food preferences and Food allergies
Why – While you will not be prescribing specific foods, this question is important to understand relative to food quality. You will likely have some of this information already presented in the client’s food logs, but having it articulated will help you gain an understanding of what topics need to be addressed in your initial conversation
Takeaway – The biggest emphasis here is dietary maturity and a client’s pre-existing relationship with food. It is very easy to write that the foods you like are “pizza, ice cream, etc…” but this also shows an underlying emphasis that is in the wrong place. If a client already has their mind in that place, it needs to be addressed on the initial phone call. This doesn’t have to presented negatively and, in fact, can be turned into a positive when explaining the flexible diet approach. However, it is also something that should be marked in your notes and discussed on a regular basis with your client.
We have found that typically clients like to label food as “good” or “bad” which can lead to some dangerous behaviors. By helping a client understand where their food preferences fit into their day, and removing the “shame” of consuming “bad foods,” you can establish sustainability from day 1 which we know is critical to success.
Why – While this may seem like a training related question (and it is), this will once again help you better understand EA (exercise activity) as well as the intensity of that exercise. Remember that this an integral part of understanding TDEE
Takeaway – This is probably the most straightforward question on the intake and we rarely see anything alarming here. However, if chronic inflammation or joint soreness is reported, it should prompt you to investigate food quality and/or GI health immediately.
Current Body Composition Photographs
Why – The data that has been provided up until this point does not really allow for an accurate measurement of body composition. However, asking a client to provide a number like bodyfat has two major problems – first it places the emphasis on yet another number and second it is usually very inaccurate. This is why we ask for pictures.
Takeaway – While the goal here is to gain a better understanding of body composition, a lot can be learned about the person’s self image. Some clients will ask to skip this part which can be very alarming. In a world where technology makes providing pictures a very easy task, the only reason for wanting to skip this part would be a very poor self image. This can reflect internal negative self-talk and/or a lack of self acceptance. This “defeated” attitude must be addressed immediately in order to have success moving forward.
Having these pictures can also prove to be useful in the long term. There will absolutely be times when the scale and other physical data points become stagnant. Having some initial pictures to compare to as an image of change can prove to be a valuable tool for illustrating success and creating continued compliance.
Description of Goals in Detail
Why – This goes without saying, but clearly we need to know WHY we are undertaking a nutritional journey. This question is the foundation for all of the work that will be done moving forward.
Important to note: While you may have your preconceived notion as to the work that needs to be done, understanding what the client truly wants is very important. All conversation and forward movement needs to be done with this in mind, not with your own preferences.
Takeaway – There is a lot to be learned from this piece. The question is specifically asked with the inclusion of the words “in detail” for a reason – we want details! Unfortunately, several clients will provide an answer like “lose fat and gain muscle.” Clearly this lacks detail, but it also shows a lack of understanding or identification of a real reason behind why the client even wants to undertake this process. This is not entirely bad but does need to be addressed on the call so that you, the coach, have a better understanding of how to keep the client motivated.
It is important to establish very clear goals with the client, as well as to help the client understand what the process will look like to establish those goals. When a goal is crystal clear the process can be mapped out. If a client has an understanding of that process, compliance tends to be much higher. But this all starts with being very clear on the goals.
Any other relevant information
Why – This is the client’s opportunity to go crazy and to express themselves to you. You can learn a lot about a client’s history here if they are open to it.
Takeaway – You should not have any expectations with this section. Some clients will immediately feel comfortable and open to talk about everything and others will include nothing. Both are acceptable.
If a client does write you a novel, be prepared to work very closely with this client and provide a lot of support and feedback.
Conversely, if nothing is written be prepared to ask a lot of questions. Sometimes a client needs to simply learn to trust you more before opening up.
Remember that a successful coaching relationship is built on trust – use what you learn in this section to build trust in your working relationship.
What do you want to know?
It is important to note that while we have listed what we believe are the critical elements of an intake form, you should also be on the lookout for anything that you frequently find essential.
Every coach will have their own unique style, and will develop their own unique relationships. This is what makes coaching an “art.” If you find that you are consistently asking questions that are not included in your intake form, go back and add them.
This should be a “living document,” one that you can amend at any time to give you the best possible information base to move your clients forward.