The Healing Path To Your Highest Potential
Noble One Coaching Discovery Form
"Everyone has something that blocks them from the full expression or experience of their Nobility."
The Basics
Date
*
-
Month
-
Day
Year
Date
Which coaching path are you interested in?
*
Individual Coaching
Group Coaching
Courses
Community Membership
Client Name
*
First Name
Last Name
Client Date of Birth
*
-
Month
-
Day
Year
Date
Client Phone Number
*
-
Area Code
Phone Number
Client Email
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Minors
If Client is Under 18
Legal Guardian's Name
*
First Name
Last Name
Legal Guardian's Phone Number
*
-
Area Code
Phone Number
Best Contact E-mail
*
example@example.com
Mental Health History
Is the client currently in counseling, therapy, or any other type of support?
*
Has the client been diagnosed by a licensed clinician? If yes, what is the condition and who is the clinical contact?
*
Discovering You
Noble One is excited to learn more about you! The following questions will help us understand how and where to guide you on a healing path from where you are now to where you want to be. Noble One's intention is to assist you in identifying challenges and transforming them into opportunities for emotional and spiritual growth. You choose the path and we empower you with self acceptance, emotional awareness, and alignment to the highest version of yourself.
What areas would you like to work on with a coach? Check any that apply.
Spiritual Awakening Guidance
Intuitive Tuning and Inner Connection
Creating and Attracting Healthy Relationships
Emotional Awareness and Coping Skills
Discovering a Sense of Purpose
Self Confidence and Self Acceptance
Assertiveness & Setting Boundaries
Developing a Self Care Practice
Loneliness or Isolation
Finding Your Voice and Courage to Speak Up
Other
What is the current situation that brought about the desire to work with a coach?
*
What are your thoughts about emotional awareness?
What are your 3 biggest emotional challenges right now?
*
What tools and practices are you currently using to cope with challenges?
*
Are you comfortable with change and how do you handle it?
*
?
On a scale of 1-5, how good are you at speaking up when something bothers you?
*
1
2
3
4
5
Not a Word About It
Shout It Out Loud
1 is Not a Word About It, 5 is Shout It Out Loud
What are your top 3 goals that you'd like to work on?
*
How much self love do you feel you have right now ? (Click 1-10 hearts)
*
1
2
3
4
5
6
7
8
9
10
What motivates or inspires you?
*
What kind of support or guidance do you feel you need right now?
*
Describe what living your "best life" would look and feel like with no obstacles:
*
Do you feel you have the desire or willingness to commit to a weekly meeting with your coach?
*
Yes
No
Is there anything else you would like to share with Noble One that will help us get to know you better?
*
Save
SUBMIT NOW
Print Form
Should be Empty: