Core Intake Form

Welcome to BrainToGame

Understand the brain. Read the game. Perform under pressure.

Before our first session, take your time to complete this form honestly and specifically. Your answers help us understand your current situation and create a clear starting point for your development.

This is not a test. There are no perfect answers. The more honest you are, the more useful the first session will be.

Estimated time: 25–40 minutes

Full name * Email address *

Player Information

Basic information about you as a player.

Age * Current club and team * Current playing level * Main playing position * Secondary position(s) Preferred position *

Dominant foot *

Left Right Both

Number of team training sessions per week * Number of matches per week/month *

Do you currently do extra training outside team training? *

Yes No Sometimes

School/work situation * Current injury or physical limitations *

Football Profile

Your football background, strengths and development points.

How long have you been playing football? * What is the highest level you have played at? * What are your 3 biggest strengths as a player? * What are your 3 biggest development points? * What kind of player are you right now? * What kind of player do you want to become? * What do you think separates you from other players? *

Current Challenge

What you are currently struggling with and why this matters now.

What made you interested in BrainToGame? * What are you currently struggling with the most in football? * When do you feel you perform below your actual level? * What usually happens in those moments? * What have you already tried to improve this? * Why is now the right time to work on this? *

Baseline Scorecard

Rate yourself from 1 to 10 for each area. These scores are not a judgment — they are a starting point. There are no right or wrong answers. A lower score is not a problem; it is useful information. Scoring yourself high to look good will make the sessions less effective. Be honest. After each score, explain in your own words why you gave yourself that number.

Pressure & Performance

How pressure shows up in your body, behavior and decisions.

When do you feel the most pressure in football? * How do you notice pressure in your body or behavior? * How does pressure affect your choices on the pitch? * How do you usually react after making a mistake? * What type of match, opponent, coach, or situation creates the most tension for you? * What currently helps you calm down or refocus? *

Game Awareness

Understanding what you see, feel and choose during match situations.

How often do you reflect on your decisions after a match? *

1 = almost never.

10 = after almost every match in a structured way.

5

Why did you give yourself this score for match reflection? * What type of decisions do you find difficult during matches? * When do you tend to rush your actions? * When do you tend to play too safe? * How do you think emotions or pressure affect your choices? * Describe one recent match situation you want to understand better. *

Development & Ownership

Your routines, responsibility and development environment.

What do you currently do outside team training to improve? * What do you do when you do not feel motivated? *

Do you set personal goals? *

Yes No Sometimes

If yes, how do you set and track them? If no, why not? * What is one thing you know would help you improve, but you are not doing consistently yet? * Who or what has the biggest influence on your development right now? *

Program Goals

Define what success looks like over the next 12 weeks.

What do you want to improve most in the next 12 weeks? * What would make this 12-week programme successful for you? * What would you notice in yourself if you improved? * What would others notice if you improved? *

How committed are you to doing the work during this trajectory? *

1 = I am interested, but not fully committed yet.

10 = I am fully committed and ready to do the work.

5

Why did you give yourself this commitment score? * What might get in the way of your progress? *

Final Reflection

Final details before the first session.

Is there anything else you think I should know before our first session? Your name to confirm * Date *

Welcome to BrainToGame

Understand the brain. Read the game. Perform under pressure.

Player Information

Football Profile

Current Challenge

Baseline Scorecard

Pressure & Performance

Game Awareness

Development & Ownership

Program Goals

Final Reflection

Thank you for completing the BrainToGame Core Intake Form.