1-on-1 Coaching

1-on-1 Coaching

You don’t need more hustle, more pushing, or another quick fix. You need space. Strategy. Support. My 1-on-1 coaching is designed to help you reclaim your energy, restore your mind, and rewrite the patterns that have kept you stuck.
Name

First NameLast Name
Age
Date of Birth

MonthDayYear
Date
Gender

MaleFemaleRather not answerOther
Phone Number
Email
example@example.com
Marital Status

SingleMarriedDivorcedWidowed
Occupation
Are you currently taking any medications?

YesNo
If yes, then please indicate the medication name and the purpose below:
What are your personal goals?
What are your professional goals?
What changes would you like to make in your life right now?
What are the things that upset you?
What are the things that makes you happy?
What is your motivation in life?
What are you willing to do to achieve your goals?
What are your professional/personal strengths and assets?
What are your expectations from this coaching relationship?
AGREEMENT/REMINDERS:

I understand that all information I entered in this form will be considered strictly confidential.

The data gathered from this form will only be used as a basis for the type of coaching the client will need.

I understand that in order to be successful, it is vital to follow the plan agreed by both the life coach and the client.
Payment Method
My Products
prevnext( X )
3 month PackageThe Reset- 6 sessions Bi-weekly with communication and workbook support between.
$300.00



6 month PackageThe Rebuild- 12 Bi-weekly session with communication and workbook support between.
$1,800.00



Free ConsultationWe will chat and discuss your goals and what you can expect from our time together.
$ Free



Total

$0.00
How did you find out about our services?

Social MediaYouTube VideoSearch EngineAdsOther
Would you like to receive product updates, news, and promos?

YesNo
Payment Methods

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

Payment Info
Should be Empty: