COACHING INTAKE FORM

Please fill out the following intake form to begin our coaching relationship. The more specific you are in these answers, the faster we can get moving in our coaching conversations.

Name

First Name

Last Name

Phone

(###)

###

####

At the end of our coaching contract, I am committed to create the following results:

Please be specific on what exactly you will be, do or have as a result of our coaching season.

These results matter to me because:

When these results become reality, what will you be experiencing internally?

Example: freedom, peace, intimacy, etc.

My current limiting beliefs (that I am aware of) around these areas of my life are:

Three people (besides myself) that will be impacted as a result of this transformation are:

If nothing happens in six months, where will your life be?

COACHING AGREEMENTS

Please click all that you agree to:

I commit to being on time to all sessions.

I understand that a session can only be rescheduled with 24 hour notice. If canceled with less than 24 hour notice, I will forfeit that session.

I understand that I am responsible for doing the hard work of pursuing my results. Nathan's commitment is to be a relentless advocate as I fight to create the above results. My results are my responsibility.

I understand that Nathan is not a licensed therapist or counselor. This is not therapy.