FTK Performance Cognition — Intake Form

Please complete the information below. The information provided will be used solely for the preparation of your personalized FTK Performance Cognition.

Name

First

Last

Date of Birth

Use format: Day.Month.Year

Birth Time

Example: 06:50 PM - give an approximate time if unknown.

Birth Location

City, State/Region, Country

Primary Performance Environment

Current Focus

What area of performance would you most like to understand?

Known Concerns

Are there any recurring challenges, frustrations, or behavioral patterns you would like examined?

Current Objective

What are you currently attempting to improve, optimize, stabilize, or achieve?

Performance Challenges

Describe the recurring performance problems, frustrations, inconsistencies, or obstacles you currently experience.

Pressure Profile

What situations create the greatest pressure for you?

Date Performance Primary

Decision Profile

Describe how you make important decisions and where you believe those decisions sometimes deteriorate.

Recovery & Sustainability

Describe your workload, recovery habits, and ability to sustain performance over time.

Additional Context

Provide any additional information that may help contextualize your current environment.

Privacy Notice: Information provided through this form is treated as confidential and is used solely for the preparation and delivery of your FTK assessment. Your information will not be shared, sold, or disclosed to third parties.