Spur Us On Coaching: New Client Intake Form

This intake form is an opportunity for you to pause and reflect on where you are right now.

Your responses help me better understand your current role, goals, pressure points, and what matters most to you. This allows us to begin our coaching work with clarity, intention, and practical next steps.

This form is designed for educational leaders and Western athletes who are interested in mental performance coaching, leadership coaching, or support with confidence, decision-making, emotional regulation, focus, and consistency under pressure.

The form should take about 15–20 minutes to complete.

During our time together, we will explore some of your reflections, look more closely at your goals, and begin identifying the insights, strategies, and next steps that will help you move forward.

Once your form is submitted and your coaching agreement has been signed, I will send a Calendly link so you can schedule your sessions. All session times are Central Time.

Name

First NameLast Name

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

What is your age?

What is your time zone and general availability?

What is your current role or occupation? (Check all that apply.)

If other, fill in here.

If you are an educational leader, what best describes your current setting?

If other, fill in here.

What leadership area are you most focused on right now?

If other, fill in here.

If you are a Western athlete, which events or areas are part of your current experience?

If other, fill in here.

If you are a Western athlete, what is your level of competition? Check all that apply.

If other, fill in here.

What area of leadership, performance, riding, work, or life are you most focused on improving right now?

What do you enjoy most about this part of your life, leadership, or performance?

When do you tend to feel most confident in your leadership, riding, competition, or performance?

What is currently feeling most challenging? Check all that apply:

What have you already tried to work through these challenges? Examples: journaling, prayer, visualization, talking with a coach, avoiding situations, practicing more, focusing on fundamentals, reading, counseling, mentoring, or other strategies.

What helps you regain focus, confidence, or steadiness after a setback?

What would you most like to improve through coaching?

What are your short-term goals right now?

What are your longer-term goals right now?

What would success from coaching look like for you?

What would you like to feel more confident doing?

What patterns do you notice that may be keeping you stuck?

What kind of support are you hoping to receive from a coach?

On a scale of 1–10, how ready do you feel to commit to the work of coaching right now?

Why do you feel now is the right time to begin mental performance coaching?

Do you feel you currently have the time, energy, and mental space to engage in coaching?

Are there any circumstances, responsibilities, or commitments that could make it difficult for you to follow through on the work of coaching right now?

Are you ready to invest in 3 to 6 months of coaching?Current coaching investments:3-Month Focused Coaching Experience includes 6, 30-minute private coaching sessions for $300; and a 6-Month Steady Growth Coaching Experience includes 12, 30-minute private coaching sessions for $550.

Optional: Is there anything else you would like me to know before we begin working together?

Optional: Do you have any existing documents or files (like a goal sheet, resume, or current plan) you wish to share?

Spur Us On: Mental Performance Coaching