Awakened Imagination Coaching - New Client Intake Form
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Age *
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Tell me about yourself! What are your hobbies? What are you passionate about? *
Is there a specific situation/event you're facing that you want to focus on in our session(s)? If so, explain: *
On a scale of 1 to 10 (Ten being your kick-ass dream life), where would you rate your life now? *
Describe your dream life / aspirations: *
In what areas of your life would you like to create the most change? *
What do you feel is missing from your life or relationship? What do you want LESS/MORE of? *
What worries you or wakes you up in the middle of the night? *
What are the emotions you feel most consistently regarding the challenges or obstacles in your life or relationship right now? *
What do you hope to achieve from coaching? *
What should I know about you to coach you most effectively? *
How familiar are you with the concept of Manifestation / deliberately creating your outcome(s)? *
Are you familiar with the teachings/works of Neville Goddard? *
Please share any other information you feel would be beneficial for me to know to best support you: *
By checking this, I agree to the terms and conditions below *
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Terms & Conditions
Terms & Conditions

Description: Coaching sessions are a creative process that educate and inspire the client to maximize their personal and professional joy and potential.  Missy is skilled at drawing out the root of her client’s current challenge and then mastering new beliefs and behaviors that can lead to realizing their hopes and dreams.

 

Responsibilities:

1.  Client understands and acknowledges that their manifestation coaching work with Missy Renee is collaborative and that the results they achieve are their responsibility.  Missy will at all times exercise her best professional efforts, skills and care to insure that client is coached to meet their life goals. Client understands and acknowledges Missy Renee will not be liable legally or otherwise, for the actions client may or may not undertake as a result of these coaching sessions.

2. Client understands that working with Missy Renee does not prevent, cure, or treat any mental disorder or medical disease, and is in no way to be construed or substituted as psychological counseling or any other type of therapy, medical or legal advice by a qualified professional.  Client agrees to seek independent professional guidance for such matters as needed. If Client is currently under the care of a mental health professional, Missy Renee requires Client inform her of their mental health condition and inform their mental health provider of their manifestation coaching sessions with her.

3. Client agrees to communicate honestly, be open to feedback and assistance, and to prioritize the time and energy to participate fully in each session.

Services: The parties agree to engage in monthly, weekly or “as needed” sessions through Zoom or telephone meetings. Missy Renee will be available to Client by e-mail and WhatsApp in between scheduled sessions for check in’s as needed.

Schedule & Fees: The fee is $300 per individual 90-minute session, $1,000 for a package of six (6) 60-minute sessions, and $2,000 for a package of twelve (12) 60-minute sessions.  All individual session fees and session packages are paid in advance or by payment arrangement. Client agrees to pay the entire amount in full and acknowledges the strict No Refund policy. Missy accepts online payments through debit or credit card, as well as PayPal.

Confidentiality: This professional relationship, as well as all information (documented or verbal) that the Client shares with Missy Renee as part of this coaching relationship will be kept confidential.

Cancellation and Refund Policy: Missy Renee does not offer refunds on coaching services. Client understands that Coaching services are a  commitment and requires full investment for the best chance at lasting success.  It is to the Client’s benefit to decide BEFORE purchasing a Coaching session or package and committing to the work that Missy Renee is the right coach for you.  

Client agrees that it is the Client’s responsibility to notify Missy Renee 24 hours in advance of the scheduled session for all reschedules and cancellations. Missy acknowledges that emergencies and last minute challenges do come up and is happy to try and accommodate such needs and reschedule said appointment for a later date.  Client will be charged for a no-call missed session or a cancellation with less than 24 hours notice.  Also, due to the scheduled times of other clients, a client may be prohibited from their full hour session if they are running late.

Limited Liability: Except for what is provided in this written agreement,  Missy Renee makes no guarantees or warranties, express or implied.

 

This is the entire agreement of the parties and reflects a complete understanding of the parties with respect to Coach and Client relationship. This agreement supersedes all prior written and oral representations.
A copy of your responses will be emailed to the address you provided.
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