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Parent Intake Form

Preparation for Elite Success Session

(Parent Perspective)

Parent & Student Info:

Parent First Name *

Parent Last Name *

Parent Email *

Parent Mobile(Phone)

Student First Name *

Student Grade *

Student Grade

6
7
8
9
10
11
12
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Primary Sport

Select your Sport

Gymnastics
Football
Soccer
Basketball
Track & Field
Baseball
Swimming/Diving
Wrestling
Volleyball
Tennis
Cheer/Dance
Other
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Training in Hour/Week *

Academic + Personal Goals:

What are your biggest concerns or frustrations right now for your student-athlete?

What are your top 3 academic priorities? *

Executive function / organization

Late work / zeroes

Time management / planning

Test prep / quiz readiness

Math or science tutoring

Writing / essay help

Stress / emotional fatigue

GPA improvement

Teacher communication

Other

Current GPA

Target GPA

What kind of support would your student respond best to?

What are the biggest schedule conflicts or stressors?

Practice schedule

Travel / competitions

AP/IB load

Illness/injury

Part-time job

Friend drama

Other

Describe your ideal outcome 90 days from now *

Is your student open to being coached?

(Yes/No)

Yes
No
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College + Athletic Planning:

Is college part of your student’s future plans?

(Yes/No)

Yes
No
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Do they want to pursue their sport in college?

(Yes/No/Not sure)

Yes
No
Not sure
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Are you currently in communication with college coaches?

(Yes/No)

Yes
No
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Do you need help navigating athletic recruiting?

(Yes/No)

Yes
No
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Do you want help preparing for college essays?

(Yes/No)

Yes
No
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List colleges/programs you’re considering

Has your student taken the ACT/SAT yet?

(Yes/No)

Yes
No
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ACT Score / Date

Academic or athletic scholarships of interest?

Communication Style + Family Dynamics:

How would you describe your relationship with your student?

What kind of communication challenges (if any) exist at home?

Who usually manages school and academic responsibilities?

(Parent/Student/Both)

Parent
Student
Both
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Anything else you’d like your coach to know?

This is where Student-Athletes Thrive.

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