Coaching Intake Form

This form helps me understand what brings you to coaching. There are no right answers. Please fill in your contact details below. For the reflection questions, share what feels useful now, and leave anything blank that you would rather talk through together.

Contact details

First name *

Last name *

Occupation *

Highest level of education (optional)

City *

State *

Marital status *

Email *

Phone (optional)

Your starting point

What brings you to coaching right now?

What matters most to you at this point in your life?

If our time together is helpful, what might feel different for you?

A little more about you

You can answer briefly or in detail. We can also explore these questions in conversation.

What feels difficult, uncertain, or especially important right now?

How has this season been affecting you? Are there thoughts or feelings you would like space to explore?

What strengths, people, practices, or experiences help support you?

What would help you feel comfortable and supported in our conversations? Anything else I should know?

How you like to work

What kinds of support sound helpful? Check any that fit.Space to think aloudReflective questionsPractical tools or exercisesEncouragementGentle accountabilityI am still figuring that out

Would you like faith or spirituality included in coaching? (optional)YesNoMaybe later