Clarity | Coaching Intake Form

Clarity Coaching Intake Form

Tell Me About You!

First Name

Last Name

What brings you here & what are you hoping to gain from coaching?

How much do the following statements describe you right now?

How would you describe your readiness for coaching?

Which one feels most true for you right now? Required

I’m ready and willing to make changes with support.

I want change, but I’m not sure I’m ready to do the work.

I mostly want to vent and be heard right now.

I’m unsure and just exploring options.

If yes, what worked or didn’t work for you?

Is there anything else you’d like me to know before we connect?

Please note: Coaching is not a substitute for therapy or clinical mental health care. If your needs fall outside the scope of coaching, I will kindly let you know and may offer referral resources when appropriate.

​Clarity Coaching Intake Form Tell Me About You!

Let's Connect

Clarity Coaching Intake Form

Tell Me About You!