New Client Forms | Studio Da Capo

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Need help recovering from an injury? Feeling overwhelmed by your schedule? Looking for support and joy?

Sarah gets it and is committed to helping you on your journey as a musician. Together, you will build physical, mental, and emotional health on your terms.

Finally! A coaching program that meets musicians where they are and addresses them as a whole person!

Client Intake Form

First and Last Name

Phone Number

What is/are your goal(s) for our work together?

Why is this goal important to you?

Are you ready to commit to the Success Path (working out with me twice weekly, doing your 10-minute home work out twice weekly, setting and achieving goals toward simple but effective lifestyle changes) laid out for you in order to achieve your goals?

Has your medical practitioner ever told you that you have a heart condition or have you ever suffered a stroke? *

Yes

Have you ever experienced unexplained pains or discomfort in your chest at rest or during physical activity/exercise? *

Yes

Do you ever feel faint, dizzy, or lose balance during physical activity/exercise? *

Yes

Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months? *

Yes

If you have diabetes (type 1 or 2), have you had trouble controlling your blood sugar (glucose) in the last 3 months? *

Yes

Do you have any other serious health conditions that may require special consideration for you to exercise? *

Yes

Describe your current physical activity/exercise level in a typical week. What are you doing and for how long?

Is there anything else you would like to share with me?

I declare that the info I’ve provided is accurate & complete.

I agree that I have read Laibility Waiver and fully understand its contents and voluntarily agree to be bound to all of its terms.Liability Wavier.

I have read and fully understand and agree to Studio Da Capo'sTerms and Conditions.

Your Signature

Select a date

Thanks for submitting!