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1:1 Coaching New Client Application
Hi lovely, I'm so glad you are here. Once you have submitted this form I will be in touch to arrange a free discovery call, so we can explore working together ❤️ make sure you check your junk mail, in case my email lands there!
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Name, email and mobile number
Your answer
Which time zone are you in the world?
Your answer
How would you best describe your current circumstances?
Single
In a relationship
It's complicated......
Clear selection
What are the biggest challenges you are facing in your love life right now? How do these show up on a day to day basis?
Your answer
Describe in your own words what you most desire from our coaching journey together/ how you would like to feel by the end.
Your answer
Briefly outline your significant relationships - name, age when you entered the relationship, length and then reason for ending.
Your answer
Have you undertaken coaching, counselling or therapy previously? How would you describe your experience?
Your answer
Do you know your attachment style?
Anxious
Avoidant
Secure
Fearful avoidant
Unknown
Clear selection
What are your three biggest fears about relationships?
Your answer
Have you noted any patterns in your relationships?
Your answer
Do you have a clear vision for the relationship you want? If so outline the key attributes you most deeply desire.
Your answer
Are you experiencing challenges in any other areas of your life? Briefly describe....
Your answer
How motivated are you to makes changes in your dating and love life?
Very motivated
I want to, but I'm a bit scared
I want to, but I don't know how
Not motivated right now
Clear selection
1:1 Coaching starts at £375/month on a payment plan - how would you best describe your current financial situation?
Not a problem - I'm ready to go
I really want to - but might need to find a way to make it work
1:1 is not an option for me right now - but I'd like to chat about other options to work with you, including group work
Clear selection
Please let me know three dates/times you are available to jump on a discovery call over the next 2 weeks
Your answer
How did you find me? (TikTok, Instagram, FB etc)
Your answer
Anything else you wish to share prior to our call?
Your answer
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