Life Coaching
Hello and thank you for connecting with me.

This is the first step in entering into life coaching with me.

Before we schedule your call, please fill out this form to determine what it is you would like to get to work on and to see if it’s the right time in your life to work with me and Life Coaching.

At the bottom of the page you will leave your contact information. After this is completed and I have a chance to review this, we will schedule your introductory call.

What is your motivation to seek a life coach?
Your answer
What do you most want to change?
Your answer
Why do you want to get coaching now?
Your answer
Tell me a little about yourself and where you find yourself in your life right now. What’s your greatest challenge right now?
Your answer
What outcome would make coaching worthwhile or a success for you?
Your answer
How did you find me? Are you familiar with my work?
Your answer
What would you expect of yourself in a coaching relationship? Are you willing to be responsible for your own choices, decisions, actions and outcomes during this coaching relationship?
Your answer
In my coaching, I believe all the answers you need are inside of you. If we enter into a coaching partnership, are you willing to be honest, give up excuses and take responsibility for your own results?
Your answer
Life Coaching is all about your commitment to taking the action steps that will lead you to your desired outcome. Do you feel you’re ready to make this kind of commitment to yourself right now?
Your answer
Are you in good mental health?
Your answer
Have you ever been suicidal? Are you currently under the care of a mental health professional or have you been prescribed psychotropic medications in the past?
Your answer
Phone Number
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Email address
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