Intake Form for Coaching Clients

This intake helps clarify readiness, fit, and focus for coaching. Coaching is a reflective, growth-oriented process centered on identity, formation, and aligned action. It is not therapy or crisis intervention.

First name

Last name

Phone

Which coaching service are you applying for?

What prompted you to seek coaching at this stage of your life, leadership, or relationships?

How would you describe the kind of person, leader, or partner you are becoming?

If this coaching were successful, what would be different for you six months from now?

Which areas feel most important to work on right now?

Identity clarity / sense of self

Leadership effectiveness

Decision-making

Purpose or direction

Relationships or communication

Emotional patterns or habits

Faith / spiritual integration

Other (short answer)

Short answer

On a scale of 1–10, how ready are you to engage in honest self-reflection and inner work (even when uncomfortable)?

Number

What might limit your ability to fully engage in coaching right now (time, energy, finances, support, etc.)?

Have you previously worked with a coach, counselor, or therapist?

Coaching is not therapy, counseling, or crisis care. It focuses on growth, identity, and aligned action. Do you understand and agree with this distinction?

If it becomes clear that this coaching is not the best fit for your needs, would you be open to a referral or alternative recommendation?

Anything else you believe would be important for me to know at this stage?