Name
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First Name
Last Name
Pronouns
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Email
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Phone
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Country
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What service are you interested in?
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How did you hear about me?
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Friend
Social Media
Referral | Therapist, doctor, etc.
Book
Podcast/Radio
Other Media
What changes are you seekng to make? How do you want to feel? What are your hopes and expecations? What will a successful outcome or result look like for you? (You're also welcome to work with me for the process and the insight - not everyone is looking to meet goals or experience profound changes). It's good for us to be clear about this before we begin.
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Briefly describe what would you like to work on with me. Just a general hint is enough. (e.g. sexuality, pleasure, relationships, communication, desire, personal goals, career goals, life transitions, etc):
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What approaches (if any) have you tried before to work through this? This could include; therapy, reading books, workshops, lectures, or coaching.
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Of those things, what's been helpful? What's been unhelpful? What would have made the experience better for you?
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How will you know that coaching is succeeding? (i.e; what will others see you doing differently, or what will change in your life?)
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Are you currently working with a therapist or coach? Have you in the past?
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I recognize you have options in choosing a professional coach to work with, (and I'm not your average coach.) I am very curious about you, and what matters to you in selecting a coach. What resonated for you about me/my work/my approach? Why have you selected me as someone who fits what you're seeking?
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After reading about me, and the information in the FAQs, what hesitations do you have, if any, about working together at this time? How might you manage these?
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Please indicate your affiliation with any of these communities/ identities/practices
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Is there anything else you would like me to know about your identity, values, faith, sexuality, history of trauma, etc. that may become relevant while working together?
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Is there any other information you'd like to share with me?
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