New Coaching Client Area

New Client Intake Form

Before We Begin
Thank you for taking a few minutes to complete this form. It’s designed to help me get to know you better—and to help you gain more clarity about what you want to focus on in your coaching journey.
Please allow about 15–20 minutes to fill it out.

Once you submit the form, I’ll receive it directly and send a copy to you as well.
I encourage you to keep your copy—it can be meaningful to look back in a few months and notice how far you’ve come and how your goals have evolved.

Name

First Name

Last Name

Phone

(###)

###

####

Describe your three greatest accomplishments to date

What made these accomplishments stand out for you?

What is the greatest challenge you have had to overcome?

What are three areas you would like to focus on our work together?

What will be different if you have achieved progress with these goals of focus in our work together?

How will you know you achieved those goals? What will be different?

What’s getting in your way in achieving those goals?

Who are the key supportive people in your life, and what do they provide for you?

What others describe as your top strengths?

If you chose to write a book to inspire others, what would be the title of your book?

On a scale of 1 to 10 (1 being lowest and 10 being the highest), how stressed do you feel right now ?

What are your key stressors?

How will I know as your coach that you are trying to self-sabotage your coaching goals?

Anything else you’d like me to know before we start our work together?

New Coaching Client Area

New Client Intake Form

COACHING CONNECTION