Please fill out this form to the best of your ability. In a coaching relationship it is imperative that your goals and my skills are a match. 

By completing this form, you acknowledge that this is an appointment to determine the suitability of a coaching relationship. It in no way implies that there will be ongoing appointments. Please note I am a Coach, not a Doctor nor a Professional Counsellor and will advise you to seek their professional guidance if I feel your issues are beyond my skill level.

Once we meet to discuss your main area of concern, we can decide if we move forward together. 

I reserve the right to decide if we continue together. 

Please note it can take up to 48 hours for me to respond to this request to set up an initial appointment. 

If this is a mental or physical health emergency, please see your primary care provider and call 911.