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1:1 Life Coaching Application

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Thank you for your interest in coaching with Faith Helps, LLC! Before your free 30-minute consultation, please take a few moments to complete this screener.

Your responses will help me:
  • Understand your goals and expectations
  • Ensure coaching is the right fit for your needs
  • Prepare for a productive and focused consultation

Instructions:
  1. Please answer all questions honestly and as thoroughly as you feel comfortable.
  2. Your responses are confidential and will be used only for the purpose of preparing for your coaching consultation.
  3. If any question does not apply, feel free to write “N/A.”
This screener does not replace professional mental health care. If you are experiencing thoughts of harming yourself or others, please seek immediate support from a licensed mental health professional or call emergency services.
1.First Name/ Last Name(Required.)
2.Email Address(Required.)
3.Phone Number(Required.)
4.Current State of Residence(Required.)
5.Please briefly describe why you are seeking coaching services at this time.(Required.)
6.Have you worked with a life coach before? If yes, what was your overall experience?(Required.)
7.Are you currently working with a therapist or other mental health professional?(Required.)
8.Are there any ongoing safety concerns or medical conditions that you feel the coach should know about?(Required.)
9.All coaching sessions are held virtually via Zoom. Please confirm you have access to a private, quiet space and reliable internet for your scheduled sessions.(Required.)