Welcome into coaching

Contact

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