New Client Form
Welcome, I am so looking forward to this journey with you. Please fill out this form and get it back to me asap .
Sign in to Google to save your progress. Learn more
Name: *
Date of Birth: *
MM
/
DD
/
YYYY
Country of residence
Contact number: *
Email:
Occupation/ School:
Emergency contact:
How did you learn about Tristin-Storme Coaching? (Tick your selection) *
Required
Have you had / or you have any diagnosed mental or medical disorders?
If yes, please state:
What is your intention or desired outcome for this process?
Client/Coach Relationship
My responsibilities in this process:
1) As your life coach, I am committed to assisting you with your success. I will always be honest and reflect any perceived limitations without judgment.
2) I am focused on your growth and well-being; I ask that you commit to a minimum of 5 sessions in order to get maximum benefit out of this process.
3) I promise to create a safe space wherein you may express yourself confidently. I am bound by a code of confidentiality.
4) I will offer you transformative tools that may assist you in designing a life you love.
5) I will assist you to set goals and hold you accountable with love and support.


Your responsibilities for this process:
6) As a client I understand and agree that I am fully responsible for my physical, mental and emotional well-being, including all my decisions and choices. I am aware that I can discontinue coaching sessions at any time.
7) I understand that coaching is a professional relationship that I have with my coach designed to facilitate the creation / development of my personal, professional goals and to empower myself to achieve what I set out for myself.
8) I understand that coaching is a comprehensive process that may involve all areas of my life, including work, finances, health, relationships, education and recreation. I acknowledge that the decision to face and resolve my personal challenges; to incorporate coaching tools and is exclusively my responsibility.
9) I understand that coaching does not involve diagnoses nor treatment of mental disorders as defined by the Psychiatric Association. I also understand that coaching is not a substitute for psychotherapy, mental health care nor substance abuse.

Confidentiality:
10) I am aware that everything said in these sessions is confidential and that it is a safe space to express myself.
Payment Policy:
11) Our sessions run on a pre-paid basis. For any given session (or package of sessions) full payment needs to be made in order to confirm a booking - unless an alternative agreement is made.
Cancellations & Refund Policy:
12) Cancellations
 must be done a minimum of 24 hours before a session is scheduled to begin in order to ensure a refund or to confirm the postponement of the session fee.
13) If you have not cancelled or postponed prior to a session, and you do not attend the session, you will be invoiced for your booked session.
14) Points 11 & 12 are obviously subject to extreme, unexpected circumstances, but will result in automatic postponement of a session.
15) Packages are non refundable unless in very specific cases

I, Tristin-Storme, look forward to helping you “Design a life you love”
Payment Details:
Account name: Tristin -Storme Coaching
Bank:        FNB (First National Bank South Africa)
Account no: 62908501465
Branch/Routing:        250655


International Swift Code: FIRNZAJJ

Paypal: tristinstorme@gmail.com


Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of tristinstormecoaching.com. Report Abuse
Google Forms