Journey Starter

Start Your Healing Journey Form

Client Information:

Marital status

Education and Professional Backgroun

Coaching Goals

Health and Well-being

Do you have any diagnosed mental health conditions?
Are you currently receiving any mental health treatment or therapy?
Have you ever attended therapy or counseling in the past?

Personal Growth and Development

Previous Experience

Have you previously worked with a coach or attended personal development workshops?

Additional Information

By submitting this intake form, you acknowledge that the information provided will be used for coaching purposes and that your privacy will be respected. Please be aware that coaching is not a substitute for professional mental health treatment or therapy. Your coach will work collaboratively with you to support your personal growth and well-being.
Your journey is important to us, and this information will help us better understand your aspirations and how we can support you. It also ensures a clear understanding of your background and expectations. Thank you for sharing your insights with us.

Collaboration Inquiries

Collaboration Form

Client Support

Client Support Form