Please spend a few minutes reflecting upon the below questions.

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* 1. Full name, Age

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* 2. Email address

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* 3. Marital status (never married, married, separated, divorced, widowed)

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* 4. What is your profession?

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* 5. Do you enjoy your work? Why or why not?

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* 6. What other modalities or practices have you interacted with to help you reach your goals? 

If you have undergone therapeutic treatment for any of the following: bi-polar/manic depression; post-traumatic stress; clinical depression; eating disorders; and/or suicide attempts, bring this up on our discovery call so we can determine together if coaching is a good fit for you at this time.

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* 7. What are three things you most want from our time together? What are three things that you want to move through/ release/ transform in our time together?

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* 8. What are the biggest challenges in your life right now?

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* 9. Do you have an intimate relationship (husband, wife, life partner, boyfriend, girlfriend, etc.)? If so, what is the quality of that relationship? What is great about it? What needs work?

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* 10. Are you ready to invest in coaching?

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