HTB_New Client Connection Questions (FEB2024)
UPDATED February 1, 2024

Welcome to HEALING TALKS BACK Coaching, Consultation and Supervision!

This work can be a deeply personal process. So, before we hit the ground running, I’d like to know a few more things about you.Your answers to these questions will give me an overarching context for where you’re currently at—and how that compares with where you want to go next.

Please answer with as much honesty and detail as you can—but also feel free to skip any questions that overwhelm you or simply don’t feel relevant. If you prefer not to answer any particular question, simply type "opt out" or "not applicable" in the response field(s).

If possible, please send me your answers at least two days before our first scheduled session.

Acknowledgements: This is my own thoughtfully curated collection of New Client Connection Questions. Many thanks to my life coaching colleagues Terri Hase and Dorit Reichental, for their inspiration and contributions throughout. 
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Email *
You are warmly invited—never obligated. *
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What is today's date? *
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What is your full legal name? *
What do you prefer to be called? *
What is your date of birth? *
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What is your mailing address? (Please note that I will never mail something to you without your permission in advance). *
In your own words, what is your current relationship status? If applicable, what is the length/duration of your current (or recently ended) relationship? *
Example: I am legally divorced. Our marriage lasted 4 years, from 2006 to 2010. I've dated a few times since, but it's hard for me to take relationships seriously anymore. Example: I've been dating my partner for 7 months, and we hope to get engaged and married sometime next year. Example: I've been engaged twice, but never married. For now, I am very happy being single.
If you're in a relationship (or if you're recently separated from someone), are you comfortable sharing your partner's name and age? *
Example: My wife's name is Jane and she's 33. Example: The guy I'm currently dating is Sam. I can't remember his exact age, but he's not much older than me and I'm 50. Example: I'm not comfortable sharing my ex's name at this time; I prefer to just call her "my ex" or "my kids' dad."
Do you have children? If so, are you comfortable sharing their names and ages? *
Example: I have three kids: Jane is 8, Joey is 5 and Jimmy is 1. Example: I do not have children. Example: I have one adult child, but I'm not comfortable sharing her name at this time.
What is your preferred cell phone number? *
May I contact you via text message and/or voicemail, using the number provided above? *
Do you use WhatsApp, and are you comfortable exchanging messages via WhatsApp when that's most convenient? *
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