LT Enterprise Client Intake Form

Name*

First NameLast Name

Phone Number*

Area CodePhone Number

Email*

example@example.com

What service did you book?*

My Products*

Business Consultation$200.00

Success Strategy Session$200.00

Personal Counseling $100.00

I need a Life Coach $2,500.00

PLATINUM LIFE COACHING— 1 YEAR Core Program Fee includes 12 months of Effective Coaching which includes: 2 individual Coaching sessions with a Life Coach twice a month scheduled by the client or coach. I WILL do the work for you! I will create a 12 month practical plan of action for the client that FITS the goals, vision, and desires that is wished to be accomplished! I will guarantee success by providing the necessary tools and resources needed to gain the desired outcome. Accountability will be required every two week to ensure the client is sticking to the plan of actions required to reach the goal. The full participation of the CLIENT is a must and is required! Scheduling is IMPORTANT and will ensure the coaching is being provided. 1 Zoom coaching session twice a month scheduled by the client (only if the client lives long distance or couldn’t make their scheduled office visit, and 2 phone accountability sessions twice a month.) Clients can call the coach line to connect with a coach) Orientation, Coaching package, 2 Assessments, and Other Program Costs! (Facilities, binders, and supplies.) A Coaching session is when the client meets with the Life Coach on a one- on-one platform. During these sessions the coach will go over the client’s vision, dreams, long-term goals, and short-term goals. These sessions are geared towards the Life Coach listening and hearing the client’s needs. The coach will create a plan of action with the client to help guide them towards resources and helpful information to conquer their goals.

I want to become a Mentee/ Mentorship$2,000.00

Mentorship Connections ~ 12 months $ 2,000.00 Membership fee 2 face to face or Zoom Empowerment Enrichment group seminar sessions once a month.2 phone accountability sessions once a month. Mentees can call the coach line to connect with a coach. Welcome package, access to the mentor line that reaches Mentor LaShawn Traylor and Zoom code for your mentorship moments.What is a Mentor?Someone who listens and encouragesSomeone who will help you help yourselfSomeone who helps you with problem- solvingSomeone who holds you accountable & encourages your responsibilitySomeone who is trustworthy Someone who helps you grow & build your confidence Someone who is well-connected & wiseA positive role model and an example Someone who challenges you in a positive wayWhat will you gain from choosing me as your Mentor? You will gain fresh insight, wisdom, accountability, direction, support, pushes you forward and towards your dreams, someone who sees and understand you.

Enter coupon

Total $0.00

What is the purpose of your session?

How do you feel I can help you?*

What is your expectation or expecting to receive from your session with me?*

How did you hear about my services?*

What is your status?*

MarriedSingleDivorceWidow

Do you have child/children

Please provide me with the best time to contact you in regards to your upcoming appointment.*

How would you like us to contact you?

Thank you for submitting your Client Intake Form! You should have already recieved an appointment time. This means I have already blocked off your appointment time and will see you at your session.

If you booked and office visit the address is:

1485 Livingston Lane Jackson, MS 39213 upon arriving please text the number 601-212-5806 to let me know you are here. THIS is not my personal number this is the coach line. Please use it when you have appointments.

If you booked by Zoom you will recieve a link the day before your session or a few hours before you appointment. Please make sure your device is properly working for your session before our meeting.

I look forward to seeing you at your upcoming meeting.

Successfully,

Coach LaShawn Traylor