SHE IS MADE LLC: 1:1 Workshop Intake Form

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You have received this form because of your interest in services for my 1:1 workshop and/or coaching services. My name is Leonora and I am the founder of SHE IS MADE. You can learn more about me in the About Tab on our website. SHE IS MADE is a community-based business, with a focal point of utilizing writing and different art forms as a tool for wellness and mental health. I am excited for you to join our #MADETRIBE.

I would love to know your needs and goals, so that I can better service you.

Please complete this form 1 week before your initial check-in schedule.

*Note: Payment must be made in order to secure your 1:1*

Email *

First and Last Name *

Prefered Name *

Today's Date *

YYYY

Best Contact Number & Contact Email *

What days and times are you usually available ? Do you have a preference day and time you'd like to partake in my workshop(s) *

Scheduled 1:1 Date ? *

YYYY

Are you familiar with using Zoom ? * Note: Virtual Meetings will occur on Zoom* *

Yes

Sort of

Please write down 3 goals that you would like to work on during this workshop(s). *

What are your long term goals in the respected areas listed above ? *

Any Additional Information that would be helpful to know ? *

How has your experience been with SHE IS MADE, thus far ? *

Submit

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