New Client Intake Form

The following questions are a way to get us started. Don’t worry about answering “perfectly.” In fact, just writing the first things that come to your mind is most productive. Take as much time as you need to compose your responses. The more detail you provide, the better.

Please email me your responses at least 24 hours prior to our first session. Thank you and I look forward to our work together!

Note: As your coach, my job is to be an ally and a resource. My job is not to diagnose you or provide treatment. I can help you discover steps you may take towards greater health and higher levels of wellness. If you have needs outside of the scope of wellness coaching, I can refer you to medical, psychological, or other health-related services. I can be a source of support, information, and accountability, helping you to follow through with any treatment plans that you devise with other health professionals.