Coaching Application Form

Name

Email

Child’s Age(s)

Location / Time Zone

What are you hoping will change with coaching?

Have you worked with a coach or therapist before? (Yes / No)

If we determine this is a strong mutual fit, are you comfortable with the financial investment required for 1:1 coaching (starting at $3,500 for a three-month engagement of consistent, structured work together.)

Comfortable with the full investment

Interested with a payment plan

Not able to invest at this level right now