Your Health Story Starts Here
Complete your confidential intake to help shape a coaching plan grounded in your health history, daily life, and goals. This page is password protected; enter HealNow to access the form.
Share Your Health History
Explore Daily Habits
Clarify Wellness Goals
A Clearer Path Begins With Understanding
Your intake gives Genesis Health Coaching a fuller picture of what you are experiencing and what you hope to change. By gathering details about your health, lifestyle, and wellness priorities before we meet, we can spend less time on basics and more time exploring patterns that may matter to you.
Douglas Howard uses this information to prepare thoughtful questions and a personalized, root-cause-focused coaching journey. Your answers help guide a conversation about nutrition, sleep, stress, movement, and other influences on your well-being—without assuming that one approach fits everyone.
What to Have Ready for Your Intake
- Current symptoms and when they began
- Past health concerns and medical history
- Existing diagnoses or ongoing conditions
- Recent changes in energy or digestion
- Relevant lab work or test results
- Questions about your health priorities
- Prescription medications and dosages
- Over-the-counter medicines you use
- Vitamins, herbs, and other supplements
- Known allergies or sensitivities
- Previous treatments and your response
- Current care from other providers
- Typical meals and hydration habits
- Sleep schedule and quality
- Physical activity and recovery
- Stress levels and daily demands
- Wellness goals and personal motivations
- Barriers to making lasting changes
What Your Intake Covers
Nutrition & Rest
Share your eating habits, hydration, sleep patterns, and any health concerns that may affect your energy and well-being.
Movement & Stress
Describe your physical activity, sources of stress, and the ways you currently care for yourself.
Daily Life & Goals
Tell us about your routines, relationships, and personal health goals so coaching can fit your life.
How the Intake Process Works
1
Open the Secure Form
2
Answer Thoughtfully
3
Build Your Coaching Plan
Your answers help shape a coaching approach grounded in your health history, lifestyle, and goals.
The intake form is password protected. Use HealNow to enter.
Questions About Your Intake
A little preparation helps us understand your starting point and make the most of your coaching experience.
What information should I have ready?
Bring notes on your health history, current concerns, medications or supplements, and any recent test results you would like to discuss.
Which lifestyle details are helpful to share?
Be ready to describe your sleep, meals, movement, stress, daily routines, and wellness goals. Everyday patterns can offer useful context.
Do I need exact dates or medical records?
No. Share what you know, and estimate dates when needed. You can mention relevant records without having every detail on hand.
What if I am unsure how to answer a question?
Give your best answer or note that you are unsure. We can explore anything unclear together during coaching.
How will my intake answers be used?
Your answers help Douglas Howard understand your priorities, identify patterns worth discussing, and tailor coaching conversations to your goals.
How do I access the intake form?
The form is password protected. When prompted, enter HealNow to continue with your intake.
