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Coaching Intake Form

Thank you for your interest in working together.

Please take a few moments to complete this intake form so I can gain a deeper understanding of where you are now and what you’re desiring to create through our connection.

Once your form is submitted, I’ll reach out within 24 hours to schedule your complimentary 20-minute one-on-one Discovery Call, where we’ll officially meet and discuss option in working together. 

Thank You.

Tammy

 

 

 

Start

Question 1 of 13

First and Last Name: 

 

Question 2 of 13

Email:

Question 3 of 13

What is your phone number to contact you? Best time to text and/or call?

Question 4 of 13

What is your full birthdate? MM/ DD/ YR

(We will use this to teach you about your Human Design!)

Question 5 of 13

Where were you born?

County, City, State:

EXACT time you were born?

(please include AM or PM)

Time:

(We will use this to teach you about your Human Design!)

Question 6 of 13

On a scale from 1-5, how committed are you to your personal growth journey right now?

1- NOT READY

3-CONTEMPLATING

5-FULLY READY

A

1

B

2

C

3

D

4

E

5

Question 7 of 13

From the items below, what areas of your life are you currently desiring more alignment, growth or support in?

(Select all that apply)
A

Creating Clarity In Your Life/ Purpose & Direction

B

Communication Skills/ Speaking Your Truth

C

Emotional Intelligence- Understand Your Emotions/ Process Emotions

D

Entrepreneur Mentoring/ Business Development

E

Healthy Boundaries

F

Leadership Skills/ Recruit Team Members/ Team Development

G

Money Management/ Money Mindset

H

Next Career Steps/ Career Change

I

Professionalism/ Work Ethics

J

Self Care / Self Love

K

Self Worth & Confidence

L

Strengthen My Relationships (Friends, Family, Partners, Business Partners)

M

Time Management (Work/Life Harmony)

N

Human Design- Tell Me More!

O

All-Inclusive Women's Retreat/Weekend- Tell Me More!

P

Let's discuss planning a Private Retreat for my friends and/or business!

Q

Reiki Healing Session- Tell Me More!

R

Silvers Healing Session- Tell Me More!

S

I have so many creative ideas; I need your help bringing them to LIFE!

Question 8 of 13

Please share any other topics you would like to address during our coaching sessions or any additional details you would like for me to know. (All information will remain confidential)

Question 9 of 13

What do you currently feel are your greatest challenges in life? in your business?

Question 10 of 13

If you could wave your magic wand, what would success look like from working with me?

Question 11 of 13

Do you have any questions for me?

Question 12 of 13

Who may I thank for referring you?

Question 13 of 13

By completing this form, you’re giving me permission to contact you to schedule your Discovery Call. Please select “Yes” below to confirm your consent.

 

A

Yes

B

No

Confirm and Submit