Parent Coaching Chat

1

Your Name* This field is required.

First Name

Last Name

2

Which of the following best describes your parenting situation?* This field is required.

Parent of a teenager who needs some help with a particular issue

A parent looking for assistance across a range of issues with raising my teenager

Parent of a teenager who is at their witts end and feeling completely overwhelmed by what is happening

3

Are you open to making changes to your parenting and working to address personal issues that may be impacting how you are relating to your teenager?* This field is required.

Yes

No

Unsure

4

Are you in a position to invest time, emotional energy, and money to improve things with your teenager?* This field is required.

Absolutely - I'm ready to do what ever it takes

Yes - but I want to know what type of commitment is required

I am just looking for some free advice

5

What has led you to reach out today to arrange a chat with Chris? (Please include some details, like the age of your teenager, the type of issues you might be facing, etc.)* This field is required.

6

If you were to work with a parenting coach, describe what a successful outcome would look like for you and your teenager at the end of the coaching process?* This field is required.

7

Have you ever had some form of personalized coaching i.e. business coaching, life coaching, wellness coaching etc?* This field is required.

Yes

No

8

How did you first hear about my parent coaching work?

Web Search i.e. Google etc.

Google ad

Social Media

Email subscriber

Word of mouth

I’ve used one of your online courses or resources

Other

9

Your Preferred EmailYour information will not be shared or used for marketing

example@example.com