Mindset Coaching Services

Full Name*

First NameLast Name

Gender*

MaleFemale

Date of Birth*

MonthDayYear

Age

years

Height

Ft. inches

Weight

Lbs

E-mail*

How did you find me?*

If you chose referral, who referred you?

Preferred Method of Communication*

Please provide preferred contact information:

What do you do for a living?

*So I know the type of stress you're under on a daily basis*

Whats the activity level at your job?

none(seated only)Moderate (light activity such as walking)High (heavy labor, very active)

Do you follow a regular working schedule, do you work days, afternoon or nights?

How often do you travel?

RarelyA few times a yearA few times a monthWeekly

Please list the physical activities that you participate in outside of the gym and outside of work.:

If you have any diagnosed health problems list the condition(s).

If you are on any medications, please list them.

What additional therapies are being undertaken for the given health problem(s)?

If you have any injuries, please list them.

What additional therapies are being undertaken for the given injury?

Are you experiencing any stresses or motivational problems?

YesNo

Do you experience challenges professionally you'd like to work on?

YesNo

Do you experience challenges personally you'd like to work on?

YesNo

Are you a current cigarette smoker?

YesNo

Your current nutrition plan could be best characterized as:

If neither, please describe your current nutrition plan as best as you can:

Please rate your readiness for change. (1-least ready, 10-totally ready)

Which of the following best describes what you want to accomplish?

If the previous descriptions doesn't do justice, please write a brief description of what you want to accomplish.

Why do you want to accomplish these goals. Please be explicit.

Timeline for achieving your goal.*

	12 WKS	16 WKS	24 WKS	32 WKS	40 WKS	1 YEAR	It'll take more than a year
NOW

Are you currently excersising regulary (at least 3x per week)?

YesNo

Have you had mindset coaching before?

YesNo

If yes, please describe your experience

At what times during the day would you prefer to get started?

MorningMid-DayAfternoonEvening

What are your expectations of me as your Coach?

How often do you want to do Coaching per a week?*

Please Choose

Are You Number 1 In Your Life?*

YesNo

If no, please list what is in the order of importance as best as you can?

Choose Your Package From TrainWithDonovan.com*

Mindset Reset - 1 Session PackageMindset Shift Package - 12 SessionsTranformation Mindset Package - 24 Sessions

Terms of Agreement for Mindset Coaching Services with Coach Donovan

Effective Date: [E-Signature Date]

By engaging in mindset coaching services with Coach Donovan (“Coach”), you (“Client”) agree to the following terms and conditions:

1. Services Provided

Coach provides mindset coaching designed to support personal and professional development. These services may include, but are not limited to, individual coaching sessions, group programs, digital content, and accountability support.

2. Nature of Coaching

The Client understands that coaching is not therapy, counseling, or medical advice. Coaching is a partnership intended to support clarity, mindset shifts, and goal achievement. The Client is fully responsible for their own decisions, actions, and results.

3. Confidentiality

All personal information shared during coaching sessions will be kept confidential, except where disclosure is required by law or with the Client’s written consent.

4. Session Policy

Scheduling: Sessions are booked in advance and held via [Zoom/phone/in-person – specify].
Cancellation: A minimum of 24 hours’ notice is required to reschedule or cancel a session. Missed sessions without prior notice may be forfeited without refund.
Lateness: If the Client is late, the session will end at the scheduled time to honor other clients' time.

5. Fees & Payments

All coaching fees are due prior to the start of services, as specified in the pricing agreement. Payment may be made via [Paypal, Venmo, Square, Check, or Cash ]. No refunds will be issued once a coaching package or session has begun.

6. Results Disclaimer

While coaching can be a powerful catalyst for change, Coach Donovan does not guarantee specific results. The Client acknowledges that outcomes are influenced by their commitment, openness, and follow-through.

7. Intellectual Property

Any worksheets, videos, frameworks, or other materials provided by the Coach are proprietary and may not be copied, shared, or used for commercial purposes without written permission.

8. Termination

Either party may terminate the coaching relationship at any time with written notice. Unused sessions will be subject to the refund policy outlined at the time of purchase, if applicable.

9. Agreement

By scheduling and participating in services, the Client affirms that they have read, understood, and agreed to these terms.

I AGREE TO THE ABOVE TERMS & CONDITIONS!*

YesNo

Client Name (Signature)*

MINDSET COACHING SERVICES

Part 1. Basic information

Part 2. Lifestyle Information

Part 3. Medical and health information

Part 4. Goals

Terms and Conditions