Coaching Intake Form

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Full Name + What You'd Like to Go By (If Different)

E-mail

Phone Number

For how long would you like to meet and how often? Most clients meet once a week or every other week. We can also see how it goes and find a rhythm that works best for you over time.

What is your availability each week?

Have you read and do you agree to the terms of the Coaching Agreement? (Write your name and today's date to confirm)

Coaching Agreement available at https://www.sapientliving.com/coaching-agreement.html

Have you read and do you agree to the terms of the Release of Liability? (Write your name and today's date to confirm)

Release of Liability available at https://www.sapientliving.com/release-of-liability.html

Sessions are currently set at $100.00 each, do you anticipate any difficulty affording this fee?

Yes

Maybe

Clear selection

Is there anything else you'd like me to know about you or your needs?

Submit

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