PARENT COACHING ENQUIRY FORM
PLEASE COMPLETE WITH AS MUCH DETAILS AS POSSIBLE. Please expect a call from private number within the next 14 Business working days. Forms are checked Monday- Friday. Forms that are completed on the weekend will not be checked until Monday.
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Do you own a Cat? (Shada cannot work in households that have Cats) *
PARENT FULL NAME *
CHILD/ CHILDREN'S NAME (Please name all Children, separated with commas) *
CHILD/ CHILDREN'S D.O.B (Please name all Children's DOB, separated with commas) *
Phone number *
ADDRESS *
Email *
When is the best time to contact you? *
Please explain in as much detail as possible the parenting issues you are currently facing *
What are your parenting goals? *
What are your strengths as a Parent? *
What are your weaknesses as a Parent? *
What are your parenting philosophies? *
What is your Child/Children's personality like? *
Does your child hit, scream, shout, not listen, disobey you? *
What are your top 2-4 priorities for parenting change as a result of parent coaching? *
What are your top 2-4 priorities for behavior change with your child/ren as a result of parent coaching? *
Tell me more about your Child/Children ( Personality traits, Likes, dislikes, Interests, favourite toys/films etc) *
Any Medical issues,  behavioural issues, diagnoses or concerns I should know about *
Where did you hear about Nanny Sharz? *
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