Section 1 of 1
Trauma Recovery Coaching Application
Please complete the following questions so I can have a better understanding of why you are interested in trauma recovery coaching, if coaching seems to be a good option for your unique situation, whether or not we are a good fit, to discover if we should proceed to your FREE 15 minute consultation, or if another form of mental wellbeing support is a better option.
Congratulations on taking this step toward your trauma recovery journey. It takes courage to reach out for support. You are not alone!
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Name (first and last)
Name (first and last)
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Phone number
Phone number
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email
email
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Preferred Contact Method:
Preferred Contact Method:
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Have you previously worked with a coach, therapist, or support professional for trauma recovery?
Have you previously worked with a coach, therapist, or support professional for trauma recovery?
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What draws you to trauma recovery coaching at this time?
What draws you to trauma recovery coaching at this time?
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Are you interested in the 4, 8, 6 or 12 session coaching program?
Are you interested in the 4, 8, 6 or 12 session coaching program?
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4 session
6 session
8 session
12 session
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What specific challenges or goals would you like to focus on during coaching?
What specific challenges or goals would you like to focus on during coaching?
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How would you describe your current emotional and mental well-being?
How would you describe your current emotional and mental well-being?
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I feel stable and ready for coaching
I experience some challenges but feel able to engage in coaching
I am currently struggling significantly and unsure if coaching is the right fit
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Are you currently receiving therapy or other mental health support?
Are you currently receiving therapy or other mental health support?
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If yes, do you have your therapist’s support in adding trauma recovery coaching to your care?
If yes, do you have your therapist’s support in adding trauma recovery coaching to your care?
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Do you feel ready to commit to regular coaching sessions and any reflective exercises between sessions?
Do you feel ready to commit to regular coaching sessions and any reflective exercises between sessions?
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Coaching is not therapy but a support-focused process. Are you open to exploring self-awareness, resilience-building, and goal setting?
Coaching is not therapy but a support-focused process. Are you open to exploring self-awareness, resilience-building, and goal setting?
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What do you hope to gain from working with me as your trauma recovery coach?
What do you hope to gain from working with me as your trauma recovery coach?
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Are there any specific accommodations or considerations that would help you feel supported in this coaching process?
Are there any specific accommodations or considerations that would help you feel supported in this coaching process?
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How did you hear about Aware NL’s trauma recovery coaching program?
How did you hear about Aware NL’s trauma recovery coaching program?
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facebook
instgram
linked in
referral from friend/colleague
website
other
previously worked with Denise
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Final Acknowledgment
I understand that trauma recovery coaching is not a substitute for therapy, medical treatment, or crisis intervention.Final Acknowledgment
I understand that trauma recovery coaching is not a substitute for therapy, medical treatment, or crisis intervention.Question Type
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I acknowledge and agree
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