Intake form for 1:1 Coaching

Welcome!

I’m so glad you’re here. Your answers will give me a clear picture of your goals, challenges, and the support you need.

It should take about 5–15 minutes to complete. There are no right or wrong answers. The important thing is to as honest as you can. Everything you share is private and will only be used to help guide our work together. The more you share the better!

Once you finish, I’ll review your responses before our first session so we can focus on what matters most to you.

Name

What are your current goals?

Why is this/these goal(s) important to you?

What are you currently doing now to support this goal? Is it working?

What have you tired before? Was it helpful and what hasn't?

How would you rate your stress levels on a scale from 1-10? Why did you rate it that number?

Who is in your life will support you in making changes? How will they support you?

What are some obstacles (or potential ones) standing in the way, of you reaching your goals?

If I could fast forward 3 months from now, what results would you expect to see in that time?

What do you expect from me as your coach?

This is a catch-all space. Is there anything else you’d like to share that would help me better understand you, your life, or your circumstances? For example, details about your home life, relationships, career, daily routines, or anything else you feel is important.

Form submission[]

Welcome!

Join Our Free Trial