1:1 Coaching Application
Please fill out this short application to help me understand your needs and determine if this is the right fit for you.
Email *
Section 1: Let's Get to Know You
Just a few basics so I know who I’ll be connecting with. This helps me personalize our communication and honor your time and energy right from the start.
Full Name
Phone Number (if you feel comfortable)
Time Zone? 
What days/times generally work best for you?
Morning (9am-12pm)
Afternoon (1pm-5pm)
Evening (6pm-9pm)
Monday
Tuesday
Wednesday
Thursday
Friday
How did you hear about our me?
Section 2: Where are you Right Now?
Everyone comes to coaching at a unique point in their journey. These questions help me understand what’s happening in your world and what’s calling you toward support or change.
What inspired you to apply seek coaching at this time?
What are you currently struggling with or hoping to gain clarity on?
Have you ever worked with a coach, therapist, or mentor before?
What would a successful outcome from our work together look like for you?
What are your primary goals for seeking 1:1 coaching at this time?
On a scale of 1 to 5, how committed are you to making meaningful changes in your life or relationships right now?
Not Committed
Very Committed
Clear selection
Section 3: Awareness
Self-awareness is the starting point for transformation. These prompts invite you to reflect on what’s really going on beneath the surface — no need for perfection, just honesty.
What do you think is holding you back from experiencing the change you want?
How do you typically respond when things feel uncomfortable or uncertain?
Which best describes your current state?
Clear selection
Section 4: Your Level of Commitment
Real growth asks for courage, consistency, and openness. This section helps me make sure you’re ready — and that I can support you in a way that feels both challenging and compassionate.
Are you seeking short-term guidance (1–3 sessions) or longer-term transformation (3+ months)?
Clear selection
Coaching requires time, honesty, and active participation. Are you willing to do inner work between sessions (e.g., reflection prompts, journaling, or practice)?
Clear selection
Is there anything else you’d like me to know before we connect?
Section 5: About you
This is where you can share a little more of your story, your personality, and what kind of support feels best for you. There’s no right or wrong answer — just you, as you are.
Describe yourself in three words
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