Congratulations in taking the first step to achieving the results that you want in your life. In order to best support you during your sample session we ask that you take a few minutes to provide us with a little information. But don't worry! We are just as concerned with privacy as you are. We promise all of your information is confidential and will never be shared with any 3rd parties.

1) Please select the area(s) in which you would like to move forward? General Life Coaching:   (ie. relationships, goal setting, empowerment, work and life balance.) Business Coaching:   (ie. goal setting, time management, networking, marketing.) Career Coaching:   (ie. empowerment, promotions, career transition, work relationships) Leadership Skills:   (ie. staff development, relationship skills, goal setting and implementation.)   2) In addition to goal achievement, coaches work with clients toward mastering life skills. Which of the skills listed below do you feel would make the greater impact on your life? Goal Setting Overcoming Obstacles Time Management Communication Breaking down Large Goals Into Smaller Doable Tasks Relationship Staying on Task/ Focus Learning Coaching Skills to use at Home or Work Prioritizing Brainstorming Ideas & Solutions Empowerment Other (Use space at end to elaborate) Living Your Values       3) Please complete the following sentence: I am interested in coaching because I hope to   4) On a scale of 1 to 10 (10 being the greatest) how badly do you want to achieve your professional or personal goals? 1 - 2 3 - 4 5 - 6 7 - 8 9 - 10   5) So that I may respond, please provide the following information:     Full Name: Telephone Number: Email Address: Re-type Email Address: How did you hear from us: