Client Intake & Pairing

Client Intake Form

Name

First

Last

Pronouns

Email: *

Phone Number: *

Location: (e.g. City, State, Country) *

Your employer: *

Your job title:

Website/URL or LinkedIn Profile

My main focus area is: *

I would work better with a coach whose style is: *

I would prefer the coaching approach to be: *

Would you rather? *

Most coaches will give you some type of homework between sessions to make sure you see progress. What do you prefer? *

How do you handle feelings and emotions? *

Any other coach preferences you’d like to note? (e.g. gender)

I would like my coaching sessions to be:

Do you have a preferred coach? Coaches’ bios can be found here “here”

What do you want to learn as part of your journey during this program?

What do you hope to get out of coaching?

How will you know this coaching engagement has been successful?

If you have a goal in mind, please write it below:

What about that goal scares or concerns you?

Do you have any additional comments, requests or preferences? Anything else your coach should know?

If you are human, leave this field blank.