INBLOOM INITIAL CLIENT FORM

InBloom.love - Initial Client Form

Please have both the Initial client form and the Coaching Agreement completed before our initial session. These forms will help deepen discovery and prepare you for understanding the frameworks of our time together.
Name

First NameLast Name
Email
Please provide the best email address to contact you.
*By signing up as an InBloom client, you may receive occasional email updates.
Phone Number
This number will be used for professional communications and coaching calls in the event of technical or weather-related issues.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Scope of Practice Disclaimer
I acknowledge that InBloom services are not a substitute for psychotherapy, counseling, medical treatment, or medical advice. InBloom coaching does not replace therapy in that it cannot serve individuals who suffer from mental illness, addiction, substance abuse, and generally low-functioning individuals who would benefit more from specialized treatment and counseling. I agree to seek appropriate professional help if needed.
Agreement - Scope of Practice Disclaimer
Responsibility of Ethics & Standards
InBloom coaching is a collaborative process aligned with the ethical standards of the NBHWC and ICF. As your coach, I offer guidance, reflection, and practical tools to support your experience. By participating in InBloom services, you acknowledge that coaching is a shared partnership — and that your own insight, engagement, and follow-through are essential to your progress.
Agreement - Responsibility of Ethics & Standards
What are the closest relationships in your life right now? (Who do you live with, and who are your greatest sources of connection, support, or companionship?)
What would be helpful for me to know about your current career path or season of work? (This could include work, school, retirement, caregiving, or anything else that feels relevant.)
What would you enjoy receiving through our sessions together?
What areas of your life feel like they’re asking to be tended to or explored more deeply right now? (This could include anything that’s calling for your attention—internally or externally.)
On a scale of 1–10, how important does it feel to tend to these areas at this time? (1 = not very important, 10 = feels imperative or urgent)
What repeating patterns, blockages, resistances, or obstacles might you feel most meaningful to explore in our sessions together?
What matters most to you in life? What are your values? (Briefly name or describe a few values you have that could bring about clarity and insight in our sessions.)
Is there a dream, vision, or idea stirring in you right now—whether big or simple? (This could be something you’re already working on, just beginning to imagine, or hoping to explore more deeply or continue with during our time together.)
In what ways are authentic awakening, purpose, and alignment important to you throughout our time together?
Name 3 inner strengths of yours that could be useful allies to remember throughout our time together.
What do you genuinely enjoy or appreciate about yourself?
How would you describe your current level of stress on a scale of 1–10? (1 = very calm, 10 = extremely high.) Also, if you’d like, feel free to share what’s been feeling most stressful or activating lately.
On a scale of 1–10, how would you describe the overall quality of your life right now? (1 = feeling very low, 10 = feeling deeply fulfilled)
If you feel it important to share, what spiritual/religious practices or rituals, if any, do you engage in for your inner well-being or spiritual growth?
What in your life brings you joy, lightness, or a sense of inspiration? (It can be anything—a passion, a place, a relationship, soft pillows, or a pet.)
Do you feel guided or inspired by any particular tradition, lineage, way of life, or higher presence? If so, what does that guidance offer you? (If there are any particular figures, high beings or teachers that motivate your outlook, you can share those as well.)
What tends to help you stay on track, aligned, and accountable?
How would you like me to be a supportive ally for your alignment and self-growth if any challenges should arise?
How can I best support you in the coaching relationship? Tick all of the boxes that resonate most with you.
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InBloom.love - Initial Client Form