Discovery Call Intake Form

Taking this step usually means that something important in your life is asking for your attention. I’m glad you’re here.

Please complete this brief form before scheduling your Discovery Call.

It gives me helpful context, so we can use our time intentionally and determine whether this work is aligned for where you are right now.

Once the form is submitted, I’ll follow up via email with next steps and scheduling.

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Email *
Name *
City + State of Residence *
Which of the following best describes your current relationship status? *
How did you find me? *
If you answered "Referral," please share who referred you. Otherwise, answer "N/A."
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How many years have you and your significant other been together in total, including dating? *
Do you have any children? If so, how many, and what are their ages? *

If you had to name one thing that feels most "off" right now, what would it be?

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In navigating this, how do you see your role — and where do you feel most challenged internally?

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What made you decide to reach out now instead of waiting?
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What kind of support have you already tried, and what has or hasn’t helped?

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If this season of your life felt resolved, what would feel different — and what are you hoping to gain from working together?

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What has staying in this current pattern/situation already cost you — and what concerns you most if nothing changes?

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On a scale of 1–10, how ready are you to actively invest in resolving this season of your life?
 (1 = just exploring, 10 = ready to take decisive action)
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Are you prepared to make a decision on our call if we determine this is aligned?
 *

If we determine this is aligned, are you prepared to invest in a 5-month private coaching container?

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Is there anything else you want me to understand about your situation before we speak?
 *
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