Advice Actually Intake Form
Filling this out will help you get the most out of your time working with me.
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Email *
First name *
Last name *
Address
What are you wanting help with? (Please be specific and detailed.) *
What have you already tried? *
What do you think is keeping you from achieving your goal?
If we worked together, what would you like to see happen over the next 3 to 6 months in order to make this a successful experience for you? *
What is your personality like? What kind of coaching style do you prefer: direct / gentle / challenging / etc. ? *
What major changes have you experienced in the last 2 years? *
What 5 adjectives would someone use to describe you at your best?
How would they describe you at your worst?
What causes you to feel motivated? *
What is your personal and/or professional vision of where you want to see yourself a year from now? Be as specific as possible and as descriptive as you would like. *
What intentions do you have for your life presently? *
On average, clients invest $5,500 - $15,000 with me. Are you ready to invest in yourself? *
On a scale of 1-10 (10 high), what is the quality of your life today?
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