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Both/And Coaching Request
Thank you for your interest in 1:1 or group coaching through Both/And. Please fill out the intake form below to request a coaching session with one of our facilitators! We will recommend available coaches to you, upon receiving your request.
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First Name *
Last Name *
Pronouns (if you'd like to share)
Email *
Self-Identify *
Please list any of your identities that you'd like to share (race, gender identity, sexual orientation, ability, mental health, etc). We especially encourage you to identify racially. For more on why, please read about our approach on our website.
What are you interested in working on in your coaching sessions?
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What sliding scale rate will you be selecting for your coaching sessions? (If you are unsure, please visit our individual pricing guide for more information.)
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If you have a discount code you'd like to apply to your coaching purchase, please list is below
Would you be interested in purchasing a coaching package at a discounted rate?
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Anything else you would like to share?
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Where did you hear about us?
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