PWG Power Water Golf Sports Fitness Training LLC

Palm Harbor, FL • (615) 481-0477 • willie@pwg-aquatic-sports-fitness.com

PWG Organizational Client Intake & Needs Assessment Form

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1. Organization Information

Organization Name

Website / Social

Street Address

City

State

Zip

Primary Contact Name

Title

Phone

Email

2. Organizational Overview

Type of Organization Corporate Nonprofit Educational Municipal Other

Employees / Participants

Brief Description of Mission / Services

3. Program Interest Areas

Golf Performance Training Aquatic Fitness & Therapy Staff Wellness / Workplace Fitness Adaptive / Inclusive Fitness Special Events or Workshops Other

4. Goals & Objectives What are your top goals and desired outcomes?

5. Facility & Resources

Access to an aquatic facility?

Pool size/depth/accessibility

Facility Location

Available Equipment

6. Preferred Scheduling & Timeline

Desired Start Date

Frequency / Duration

Availability (Days/Times)

7. Budget & Administrative Notes

Budget Range or Funding Source

Billing Contact Name & Email

Special Requirements or Notes

8. Authorization

Name

Title

Date

By submitting, you confirm the information provided is accurate to the best of your knowledge.

PWG Power Water Golf Sports Fitness Training LLC • Palm Harbor, FL • (615) 481-0477 • willie@pwg-aquatic-sports-fitness.com