Couple Coaching

Welcome in this space devoted to couple’s support and thriving !

Thank you so much for taking the time to fill intake form. I am curious to getting to know you and excited for our work together.

Please take some time to fill out the following questions that will support me in getting to know you better and serve you best in out coaching work.

HOW TO FILL THE FORM
You can fill the form together or separately.
Don’t worry about answering it right, or your answers not matching your partners answers. If for some field you feel you want to answer differently, you can either write 2 different paragraphs or fill up your forms separately.
Simply say what is right for you now, and know that it might change.

Name *

First

Last

Name *

First

Last

Email addresses of both partners *

Telephone number

In terms of personal development, what other methods or practices have you interacted with to help you reach your goals so far? *

What are three things you most want from our time together? What are three things that you want to move through/ release/ transform in our time together? *

What do you feel are the best qualities of your relationship?

What are the biggest challenges in your couple right now? *

What are you afraid of about working together?

At the end of our coaching, how would you like to feel/how would your life look like? *

Health history - Is there any other information about your physical or mental health that you feel is relevant for me to know?

I understand that coaching doesn't replace therapy nor medical advice. If you have undergone therapeutic treatment for any of the following: bi-polar/manic depression; post-traumatic stress; clinical depression; eating disorders; and/or suicide attempts, bring this up on our discovery call so we can determine together if coaching is a good fit for you at this time.

I understand that coaching doesn't include nudity during sessions. Any intimate practice will be assigned as homework, to be done in privacy.

I understand that by submitting this form, I'll will join Conscious Birth newsletter