Sheba's Lifestyle LLC
Free 10-Minute Consultation Form
Mind • Body • Soul
Contact Information
Full Name:
Phone Number:
Format: (000) 000-0000.
Email Address:
example@example.com
Preferred Contact Method:
Phone Call
Text Message
Email
Zoom/Video Call
Consultation Interest
What would you like support with during your free consultation?
Consultation Interest Options
Mental Health Support & Wellness Guidance
Spiritual Guidance & Encouragement
Both Mental Health & Spiritual Guidance
Weight Loss & Lifestyle Coaching
Motivation & Accountability
Stress Management
Confidence & Self-Love
Other
Short Check-In
What inspired you to reach out to Sheba's Lifestyle today?
Back
Next
What is one goal you would like to work toward?
Scheduling Preferences
Preferred Day(s):
Preferred Time(s):
Important Disclaimer
Sheba's Lifestyle LLC provides life coaching, wellness support, motivational guidance, and empowerment services only. Services are not intended to diagnose, treat, or replace professional medical, psychological, psychiatric, or licensed therapeutic care.
If you are experiencing a mental health crisis or emergency, please contact 911 or a licensed mental health professional immediately.
Agreement
I understand this is a free 10-minute consultation intended to discuss goals, support options, and possible next steps.
I understand Sheba's Lifestyle LLC does not provide licensed medical or clinical therapy services.
Signature:
Date:
-
Month
-
Day
Year
Date
"Where wellness meets self-love."
IG: @shebaslifestyle
Email: Shebas.lifestyle.llc@gmail.com
Preview PDF
Submit
Should be Empty: