Coaching Application

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Name
First Name
Last Name
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Email
example@example.com
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Phone Number
Area Code
Phone Number
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What type of coaching are you looking for?
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What goals or objectives do you have working with a coach? Provide as much detail as you feel comfortable with.
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What challenges have held you back from reaching your goals in the past?
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How do you best receive information in communication? (ex. firm, direct, softer approach, etc.)
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How do you currently talk to yourself in the face of setbacks?
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Have you worked with a coach before? If so, what was your experience?
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What are your expectations in the coaching process?
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What frequency do you think is best for you to see results?
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What days/times are best for you for coaching?
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To your desired comfort level, please anything additional you think I should know about you.
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My rate is $164 per hour. However, I am passionate about every person having access to a coach. For that reason, I offer a % of my business on a discounted rate. If the discount group is full, group coaching may be an option to ensure you get the support you need. Please share what option you see yourself in.
I'm OK with the hourly rate Jen!
I might need a discount!
I'm OK with the group coaching if there isn't a discount available!
I LOVE the idea of group coaching!
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Please verify that you are human* This field is required.
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