Consultation Request

Your Real Work Is You

It’s very exciting when someone takes action in the direction of courage and change. So thank you for reaching out!

The confidential answers you submit here will help me assess whether we could be a good fit for a coaching partnership. Within 48 hours of receiving your respones, I’ll be in touch to either schedule a complimentary intro consultation or to refer you to resources that I think you’ll find helpful.

During our 30-40 minute consultation, I will take the time to understand your current challenges and vision, and you can ask me any questions you want; hopefully in that time you will get a good sense of what working with me would be like. I look forward to being in touch!

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Name*
First Last
Email*
Best phone number to reach you*
How did you find your way here?
If you were referred, please provide a name so I can say thank you! If you weren't referred, how did you find this site?
Background: Tell us a little bit about yourself*
What do you do for work / where do you work? What do you do outside of work? How would you describe yourself?
What is one thing we can help you achieve or overcome?*
What would you like to get out of this coaching partnership? What are some challenges, roadblocks you are facing? What internal narratives are getting in your way?
How comfortable are you with introspection and openly sharing your feelings/concerns/challenges?
- 1 Not comfortable at all.
- 2
- 3
- 4
- 5 Very comfortable and I welcome it!
What is your highest degree earned? From where and when?
Is there anything else you would like me to know about you? Any questions about working with me?*
Questions or comments are fine here too -- if we have an intro chat, I will answer all of your questions about how I work with clients.
Email
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