Apply For 1:1 Coaching
Name
First Name
Last Name
Email
example@example.com
Phone Number
*
Format: (000) 000-0000.
Age
Occupation
Link Your Social Media Handles Below
Tell Me About You
In one sentence...Why are you here today?
If we were sitting down for coffee, what story would you tell me about your life right now?(Don't overthink it. Just write.)
What made you decide that now is the time to seek coaching?
What are you hoping will be different one year from today?
Your Dream Life
If nothing was impossible...No fear.No money concerns.No judgment.No responsibilities.
What would your life actually look like?Describe it in as much detail as you can.
What dream have you never told anyone about?
What do you think is standing between you and that life?
Getting Honest
Which best describes where you are today?
I feel completely stuck.
I know I'm meant for more.
I'm healing from difficult experiences.
I'm rebuilding after divorce, loss, or a major life change.
I've lost myself.
I want more confidence.
I struggle with boundaries.
I struggle trusting myself.
I know what I want but don't know how to get there.
Other
Which of these do you struggle with most?(Check all that apply.)
People-pleasing
Perfectionism
Anxiety
Fear of failure
Fear of judgment
Limiting beliefs
Lack of confidence
Self-sabotage
Difficulty making decisions
Burnout
Feeling disconnected from myself
Setting boundaries
Trauma or past experiences
Other
Complete this sentence:"If I could change one thing about my life, it would be..."
What belief about yourself do you wish wasn't true?
Readiness
Why is creating this change important to you?
Why does that matter?
And why does THAT matter?(Keep going until it makes you emotional.)
On a scale from 1–10...How committed are you to creating meaningful change?
Worst
1
2
3
4
5
6
7
8
9
Best
10
1 is Worst, 10 is Best
What might get in your way?
What kind of support do you need most right now?
Working Together
Have you worked with a coach or therapist before?If yes, what worked?What didn't?
What are you hoping I'll help you with?
What do you need from a coach in order to feel supported?
Investment
Creating lasting change requires time, energy, commitment, and financial investment.
If we both feel we're a great fit, are you prepared to invest in yourself?
Yes
I'd like to learn more
I'm not sure yet
Is there anything else you'd like me to know before we meet?
One Final Question
Imagine we finish working together.It's one year from today.You look back at this version of yourself with tears in your eyes.
What happened?Who did you become?What changed?Write the story.
Before You Submit...I have one request.
Please don't answer these questions with the version of yourself that has spent years trying to make everyone else happy.Answer them as the woman deep inside who knows there's more waiting for her.The woman who's ready to trust herself again.I can't wait to meet her.— Britt Marie
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