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Welcome to Resilient Life Coaching!
Thank you for your interest in my coaching services. Whether you’re seeking individual coaching, group sessions, or workshops, this form will help me better understand your needs, goals, and how I can best support you. Please take a few minutes to complete the form thoughtfully. Your responses are confidential and will help us create a personalized and impactful experience. I look forward to walking alongside you on your journey to resilience and growth! 

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"Your responses are confidential and will only be used to provide the best coaching experience possible. If you have any concerns, please don’t hesitate to reach out."

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Full Name:
Preferred Name (if different): *
Email Address: *
Phone Number: *
Preferred Method of Contact: *
Age Range: *
Street Address *
City *
State *
Emergency Contact (Name and Phone):   *

Which type of coaching are you interested in?

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Have you worked with a coach, counselor, or therapist before?  

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If yes, what was your experience like?

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What is your primary reason for seeking coaching?

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  (e.g., healing from trauma, setting boundaries, improving relationships, building resilience)  

What are your top three goals for coaching?

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What does success look like to you at the end of the coaching process?

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Are there specific skills, habits, or perspectives you’d like to develop?

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How important is faith in your daily life?

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Are you comfortable incorporating faith and biblical principles into our coaching sessions?

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Do you have a favorite scripture, spiritual practice, or personal mantra that inspires you?

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Have you experienced significant trauma or challenges that you feel are relevant to share for this coaching?

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  (You can share as much or as little as you feel comfortable.)  

How do these challenges impact your daily life?

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Have you participated in any past programs or workshops related to healing or resilience?

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Do you have a support system in place? 

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(e.g., family, friends, church community)  

Are there any relationships you'd like to focus on improving during coaching?

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Do you have any accessibility needs or special accommodations?

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Are you interested in virtual, in-person, or hybrid sessions?

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What days and times are you typically available for coaching or workshops?

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What excites you most about starting this coaching journey?

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Is there anything else you’d like me to know about you or your situation?

*
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