One - One Fitness & Wellbeing Coaching
Children & Teen's
Child's Name
Parent/Carer's Name
Back
Next
Email address
Back
Next
How old is your child?
Back
Next
How would you like the coaching to be delivered
Face to Face
Virtual
Other
Back
Next
Does your child enjoy exercise?
Yes
Occasionally
No
Back
Next
Does your child respond well to structure?
Yes
Somewhat
No
Back
Next
Is your child able to express how they feel through discussion?
Type a question
Yes
Somewhat
No
Back
Next
Does your child prefer to express themselves through something practical? Sport, creative writing, play, art, drama etc
Yes
Somewhat
No
Back
Next
Has your child been diagnosed with a special educational need or disability (SEND)
Yes
Awaiting assessment
Not been diagnosed
No
Back
Next
Does your child receive any other professional support - Please write below
Back
Next
Please tell me how I can support your child and yourself?
Back
Next
What would you like your child to achieve from the coaching sessions?
Back
Next
Phone Number -Please leave your number so we can arrange a call
Please enter a valid phone number.
Format: (000) 000-0000.
Back
Next
Submit
Should be Empty: