Introductions & Intake
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Email *
Last Name *
First Name *
City *
State *
Country *
Phone number (optional)
How should I be in touch? (email is preferred, but let me know what works best for you!) *
What is your age range? *
What are your pronouns? *
What is your racial or ethnic identity? (optional)
In what time zone will you be making most of your coaching calls? *
In what area(s) of your life are you seeking coaching? *
Required
If you chose "Professional" above, please tell me a bit about your current industry and/or role.
At the end of 10-12 coaching sessions, what new perspective, skills or practices do you hope to have? Why is that important to you? *
My ideal coach would... *
Must have!
Great, but not necessary
Would prefer not
Share my gender identity
Share my racial or ethnic identity (please identify this in question 11 above if this is important to you)
Be of a similar age
Offer lots of reading (books or articles)
Offer lots of podcasts or videos
Have expertise in my profession or industry
Have a religious background
Is there anything else you would like me to know before our first call? (optional)
Did someone refer you? (optional)
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