Coaching Intake
This form is used by coaches at BOLDLY at the commencement of a coaching engagement. This form does not constitute the Agreement, however works in addition as an expectation setting and prep-work tool. The content collected here is confidential between the coach and coachee. This form may take 15-30 minutes to complete, depending on your level of detail and reflection.
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My first name is: *
My coach's first name is: *
Today's date is: *
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I understand that coaching is not therapy, and that my coach will seek to refer me to an appropriate professional if needed. *
Required
My current mental health status includes (click all thoughts, feelings and behaviours that apply - please note that none of these symptoms preclude you from undertaking coaching): *
Required
I understand that coaching is confidential, except in situations where my coach believes I, or someone close to me, may be at risk of harm. *
Required
I understand that if at any stage I am concerned about the conduct of my coach, I can email connect@boldly.app *
Required
I will be motivated and committed to the coaching process by preparing for each session and undertaking the agreed actions after each coaching session. *
Required
My initial goal for coaching relates to (summarise your issue, ideal outcome, and any steps you've already taken to achieve it. High level is OK - you will work closely with your coach on this through your sessions to hone your goal): *
I believe my character strengths include (click all that apply): *
Required
I will be keeping the following people abreast of my coaching engagement (list all sponsors, stakeholders, supporters by first name only - please note, your coach will not be making contact with these people): *
I have completed a psychometric assessment or 360 review in the past 18 months: *
I believe this coaching experience will be successful if... (finish the sentence) *
Thank you! To further prepare for your coaching engagement, we recommend you have a dedicated note book set aside for your in-session notes and post-session homework and reflections. You might further prepare by considering your goal, and what your ideal future state will look like. Thanks for working with us!
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