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For New Clients

Client Forms

Before we begin working together, please complete and sign the two forms below. They take only a few minutes, and everything you share is kept strictly confidential.

Form 2 of 2

Intake Questionnaire

This short questionnaire helps me understand where you are right now and what you'd like to get out of coaching, so our sessions can meet you exactly where you are. There are no right or wrong answers — and everything you share is confidential.

Please rate each statement from 1 to 5

1 = Not at all true for me  ·  5 = Completely true for me

I am ready to make changes in my life

I am willing to commit time and energy to the coaching process

I am open to honest feedback and new perspectives

I can commit to attending sessions regularly

I take responsibility for my own progress

Signature

* Required fields

Your information is kept strictly confidential and will never be shared.

Questions about these forms? Email me at elena.valencia1111@gmail.com