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Flowstate: Unleashed Performance Assessment
Client Intake Form
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Email
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First and Last Name
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Age
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Tell me about your Sport, your Position, and the level you play at
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Have you ever had performance coaching in the past? If yes, what was your experience and results?
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What are your current roadblocks?
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Do you have any current health issues or injuries?
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Please check all that apply
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You do not have well-defined goals or goal specificity. You lack direction.
You are so self-conscious; you worry about what others think about you.
You maintain many self-doubts about yourself.
You worry about letting others down by not performing up to others expectations.
You suffer from anxiety, worry, or excess tension when in competition
Pre-game jitters do not go away after the first few minutes into the competition.
You are motivated by fear of failure and it affects your performance in competition and/or life.
You have a fear of success and sabotage yourself when you are winning or doing well.
You attach your self-worth to how well you perform in sports or life.
Your routines are not well defined or lack mental focus in routine.
You go through the motions physically without mental focus or intensity.
You are distracted by things that go on around you in your environment.
Post-injury you cannot perform the way you did pre-injury even when 100% physically from fear.
When performing well, you may sabotage your performance with a comfort zone (protect your lead) or expectations that limit your ability to press forward.
You become easily frustrated because of high expectations.
You cannot perform with freedom or trust in times of adversity or pressure.
You do not concentrate in the here and now or focus only on execution.
You think of too much about consequences of your performance, good or bad.
You over analyze mistakes (technique) and thus overthink about technique.
You suffer from low self-confidence or self-esteem.
You limit your performance with negative self-labels.
You have trouble forgetting or letting go of bad past performances.
Your anger or frustration gets in the way of peak performance.
You are frequently disappointed with your performance and wish it was better.
You have a burning desire to be the best at your sport or want to know how to improve your mental game.
You keep reinjuring yourself
You are on a losing streak and are feeling frustrated
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