The purpose of this form is for me to learn a bit more about you before we begin our work together.

A few guidelines:

  • Answer as much or as little as you'd like.

  • Be as detailed as you'd like, but don't "stress" about doing this "right."

  • This is confidential. Nothing is "off limits!"

  • If you'd like to save your responses, write in a word processing program and then copy/paste below.

I'm looking forward to seeing how I can best support you.

Name *
Name
Phone *
Phone
If relevant
If relevant
I'm willing to do what's necessary and invest in myself to get results
I'm willing to do what's necessary and invest in myself to get results
Where did you hear about coaching with me?