Getting to Know You
Please answer the following questions to give Dr. Camden greater insight in to your background and how to best prepare for your coaching sessions!
Sign in to Google to save your progress. Learn more
Email *
Full name *
Mailing address (street, city, state, zip) *
Phone number *
How did you hear about Dr. Camden? *
I would like coaching for the following issue (select one): If you are not sure, please read through the descriptions of each type of coaching at https://drcamden.com/coaching/ *
Do you want individual or couples coaching? (Please note couples coaching is available for Purity Culture and Egalitarianism only.) *
Required
Spouse's name (if wanting Couples coaching. If not, feel free to share or enter N/A)
Briefly describe your history with your main issue of coaching (Purity Culture, Egalitarianism, or Faith Reconstruction). *
What strategies, resources, or tools have you already tried for this issue? (Books, counseling, personal reflection, etc.) *
Briefly describe your main issues or problems you want to address in coaching. What do you hope to get out of coaching? What are your goals? In other words, after our coaching sessions are over, what will be different in this problem area? *
Do you have any current or past mental illness, past trauma, or thoughts of harming yourself? If so, please describe and also explain what treatment you are receiving for these issues. *For active suicidal thoughts, please call 911, go to the ER, or call the National Suicide Prevention Lifeline at 1-800-273-8255. *
Please share anything else about yourself you would like me to know. This could be things like your age, family/kids, work, church and faith status, Enneagram type, etc. *
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy