Questions to start you off….

Here are some things you might want to start asking yourself as you approach our time together.  This is a starting point. It also gives me a sense of your wants and challenges. Do your best to answer and if you do not know the answers, no worries. That’s what the session is for too, to get clearer!

What would you like to have happen in our session? Where would you like to be when we finish?

What might stop you from getting what you want? Perhaps there is something that stops you in your life from getting what you want. What might that  be?

Anything else you would like me to know that can support you?

Coaching Registration & Questionnaire

Please answer the following questions to the best of your ability.  You may attach another sheet if necessary.  This information is strictly confidential.

Name

Email

Addrress

Phone

1.   Have you worked with a coach before? A therapist?  If so, how was it for you? What worked and what didn’t? And how might I serve you differently? Or the same?

2.   Have you ever experienced flashbacks, or extreme fear about physical touch?
      Do you have memories of physical, sexual or ritual abuse?  If yes, please explain.

3.   Do you have any history as the victim or perpetrator of violence?  If yes, please explain.

4.   Have you, or anyone in your family, ever been suicidal?   If yes, please explain. ease explain.

5.   Do you have any physical injuries or limitations?

6.   Have you ever lost a close family member or friend to death?  If yes, please explain briefly.

7.   What are your addictions?  What have you been addicted to in the past?

8.    Do you have a spiritual practice or belief?  If so, please describe what you have faith in.

9.     Are you currently in a “mate” relationship and do you have children?

10. This type of work can bring up some “old” stuff that may be uncomfortable to look at. Are you willing to seek support if you need it? Friends, family, counselor? What is your support network?