Let’s get started Name * First Name Last Name Email * Phone (###) ### #### Contact Preference * Choose any & all that are ideal for you. Email Text Message Phone Call What is the biggest change (or commitment) you'd like to make in your life? * What are the three biggest challenges you are facing right now? * With me as your coach, what is the first thing we should work on together? * Do you feel any hesitation about getting started? If so, can you describe it? * How do you define success for yourself at this stage of your life? * What are you most passionate about? * What is your spiritual, religious, or non-religious practice like? * In the last 3 months... * This is for us to get a gauge of your experiences recently. I've experienced harmonious physical, mental & emotional health Strongly Disagree Disagree Neutral Agree Strongly Agree I've experienced a harmonious relationship between me & the universe Strongly Disagree Disagree Neutral Agree Strongly Agree I've set and accomplished goals successfully Strongly Disagree Disagree Neutral Agree Strongly Agree I've taken good care of myself Strongly Disagree Disagree Neutral Agree Strongly Agree Are there any emotional, cultural, or spiritual sensitivities I should be aware of? * Coaching Statement * My coaching practice operates with the ICF (International Coaching Federation) model of coaching, which is client-centered. This means that as a coach, I do not give advice, counsel, or consult on your life. Instead, I ask questions that allow you to guide our session and discover that the answers are within you. This allows you, the client, to recognize your own power and autonomy as a free human being. Please check the box below to indicate that you understand this. I understand Important Notice: Everything in this form is completely confidential, only to be seen by me directly. Once you submit this form, you will have access to our booking portal. Please schedule our session using that link. If needed, I will follow up with paperwork before our first session. Thank you so much! I really look forward to connecting with you.Click here to book our first session at your convenience.Please make sure that the name on your booking matches the name you put on the form.