Private Coaching Client Form...Confidential

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Personal Insight:
Married or PartnershipSeparatedDivorcedWidowSignificant BreakupSingleEmpty NestOther (please fill-in)

Business name - If applicable.

Business website - If applicable.

What does your existing business or new one offer, or state not applicable?:

What are the top 3 issues you would like to be coached on?:*

Why are these 3 issues important to you now?:*

What do you expect from working with Beth?*

Please share why you are contacting Beth today?:*

What would you like your "life" including your goals and vision to look like in 3 months?:*

What are the 3 things that you would like to achieve, receive, or accomplish in 12 months?:*

Do you have the finances to start your coaching journey this month?*

Do you believe in complementary and holistic wellbeing practices such as meditation, Silent Counselling, Yoga Nidra, Theta Healing, Reiki and more?*

What would Beth not know to ask you that is of importance to you?:*

Have you or are you currently being treated for depression or anxiety by a health professional?:*

Do you have any health or medical conditions that are being treated by a health professional?:*

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