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APPLICATION FORM
Full name
Where are you from?
Email
Phone
In which areas of your life do you want our sessions to be focused on? Please list three, starting with the most important.
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What is your ultimate goal in life?
Why are you seeking koaching?
What do you struggle with the most in terms of self-awareness?
Are you serious about making a change, and are you willing to put in the work necessary to become the best version of yourself? If so, why?
Wednesday
Morning (6am - 8am PDT)
Midday (12pm - 2pm PDT)
Afternoon (3pm - 5pm PDT)
Friday
Morning (6am - 8am PDT)
Midday (12pm - 2pm PDT)
Afternoon (3pm - 5pm PDT)
What is your availability? Please select all that apply
Saturday
Morning (9am - 11am PDT)
Midday (12pm - 2pm PDT)
Afternoon (3pm - 5pm PDT)
Sunday
Morning (9am - 11am PDT)
Midday (12pm - 2pm PDT)
Afternoon (3pm - 5pm PDT)
Coaching Agreement: I understand that coaching does not involve the diagnosis or treatment of mental health issues. I understand that coaching is not a substitute for counselling, psychotherapy, psychoanalysis, mental health care or substance abuse treatment and I will not use it in place of any form of diagnosis, treatment or therapy. If I am currently receiving psychiatric care, I will consult with my caregiver to ensure working with a coach is in my best interest at this time.
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