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RCT Fall 2023 Individual Coaching Client Questionnaire
Interested in getting individuals relationship coaching? Answer a few questions here! Remember, if you've already received coaching through our program, you are not eligible to apply at this time. If you want immediate coaching we recommend visiting:
https://relationshipschool.com/myrelationshipcoach/
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* Indicates required question
Email
*
Your email
Where did you hear about this relationship coaching offer?
*
The Relationship School FB Page
Jayson Gaddis FB Page
Smart Single FB Page
Email from The Relationship School
Friend
Relationship School Student or Coach
Instagram @therelationshipschool
Facebook Group
Other:
If you answered "Friend" or "Relationship School Student or Coach" to the question above, please provide their name here:
*
Your answer
Your First & Last Name
*
Your answer
Email Address:
*
Your answer
Phone Number:
*
Your answer
Location/Time Zone?
*
Your answer
Why are you interested in 1:1 coaching with one of The Relationship School's coaching students?
*
Your answer
Describe your overarching relationship issue that you want challenge/support with:
*
Your answer
What is your relationship status?
*
Single
Separated
Non-serious dating relationship
Married
Divorced
Non-married committed relationship
Widowed
Do you agree to be matched by the TRS Team with a Relationship School coaching
student
, who is supervised and trained by Jayson (but at no time will receive direct coaching from Jayson during these sessions).
*
Yes
No
You will be working with a new Coach-in-Training and your time and financial commitment are extremely important. Are you able and prepared to attend 2 sessions per month for 3 months, and pay a total of $150 which includes the $25 application fee?
*
I confirm that I have read, understand and agree to the above statement
Have you had a history of significant trauma? If yes, please briefly explain.
*
Your answer
Please acknowledge coaching with coaches in training at The Relationship School is focused on relational skill building and is not a substitute for trauma work, which should be done with a licensed therapist or counselor.
*
I confirm that I have read, understand and agree to the above statement
Have you ever been diagnosed with a mental illness before? If yes, what?
*
Your answer
Are you currently taking medication for mental health? If yes, what medications and are you working with a psychiatrist?
*
Your answer
Are you currently in a life-threatening or dangerous situation? (This includes domestic violence, abuse, stalking, coercion, current trauma, or other such behaviors and actions.)
*
Yes
No
How much experience do you have as a client in therapy or coaching? List what modalities and how long.
*
Your answer
Do you understand this coaching is specifically geared to your relationships and not life coaching or business coaching, etc.?
*
Yes
No
Do you understand this is an application process, and you may not be selected for coaching (or may be selected later in the process). If you are selected, it may take up to a few weeks before you are contacted about student coaching?
*
Yes
No
Lastly, Have you paid your
$25 application fee
? If not, do that
here
now. (We must receive your application fee in order for you to be considered for coaching.) Remember, the $25 application fee will be credited to your first session.
*
Yes
No
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