New Coaching Client Enrollment Form
Your Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact
*
First Name
Last Name
Relationship
*
Phone Number of Emergency Contact
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email of Emergency Contact
*
example@example.com
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For creating the natal chart, please share your full date of birth (month, day, year), exact time of birth (mention if it's exact time or approx.), and city, state/region, country of your birth.
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What is your current occupation? How does your daily schedule usually look like?
Please describe your relationship status (i.e. single, dating, married, divorced, have children, living with parents, etc.)
Please describe your living situation (ex. Live in downtown Jersey City, NJ with a roommate in apartment or live upstate New York with family in a single-family home)
How is your physical health? Do you currently have any ongoing treatment or health challenges? Do you have any regular physical practice? How is your sleep?
How do you feel about your diet? Do you consume alcohol? If yes, how much/how often? Do you smoke?
Do you use any recreational drugs and/or mind altering substances? If yes, how much/how often?
Do you have (or have had) any addictions? (Food, drugs, sex or other) Have you addressed it?
How would you describe your mental health? How would you describe your spiritual beliefs? Do you believe in God/Universe/Creator/Higher Power? If so, how do you feel comfortable to call It? Do you have any spiritual practice?
What is your intention for the session? What are your current life lessons or challenges? Anything else you'd like to share?
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All answers are strictly confidential however, as a minister I am obliged to report to authorities if a client is threatening own life or the lives of others.
What is the number of sessions you'd like to commit to? (Rates for the sessions can be found on https://starsguiding.me/star-coaching/
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