Life Coach Intake Form

TransforMagickal Life Coaching

A holistic approach to unleashing the magic within.
Life Coach Intake Form
Name

First NameLast Name
Age
Date of Birth

MonthDayYear
Date
MaleFemaleNon BinaryTransgenderPrefer not to say
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
SingleMarriedDivorcedWidowed
Occupation
YesNo
If yes, then please indicate the medication name and the purpose below:
YesNo
If yes, then please share them below:
What are your personal goals?
What are your professional goals?
What changes would you like to make in your life right now? What is one thing you want less of?
What are the things that upset you?
What are the things that makes you happy? What is one thing you want more of everyday?
What sparks your passions/motivations?
What does journey and shadow work mean for you?
What is a new perspective you would like to gain?
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.
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30 minute consultation
1:1 consultation to ensure this program is a good fit, we will discuss health history, goals and explore what services are the best fit for your unique needs.

$ Free



1:1 integration session
60 minute 1:1 session

$80.00



1:1 Breathwork/bodywork/soundbath 1 hour
60 minutes of 1:1 in person breathwork coaching/bodywork with touch and energywork and sound healing.

$111.00 Quantity



1:1 Breathwork/bodywork/soundbath 2 hr
120 minutes of 1:1 in person breathwork coaching/bodywork with touch and energywork and sound healing.

$222.00 Quantity



Journey with pre/post session coaching
Ensure the best mindset and setting for your journey and ensure your journey is facilitated safely and skillfully. You are supported from beginning and beyond. 2 pre session and 4 post session 1:1 sessions and 3 virtual group integration circles are included.

$1,400.00 Quantity



Monthly Shadow Work coaching package
Cultivate your most magick self with this 4 coaching session package with unlimited virtual shadow work group sessions.

$222.00 Quantity



Total

$0.00
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TransforMagickal Life Coaching

Life Coach Intake Form