Discovery Coaching Session Intake Form

Resurgence Leadership - Life Coaching Intake Form


Welcome — I’m really looking forward to meeting with you. This brief questionnaire is designed to help us make the most of our time together. Your honest reflections will help me better understand your goals, strengths, and hopes for coaching — so that our session can be as meaningful, focused, and productive as possible. Everything you share here, and in our coaching sessions, will be treated with strict confidentiality, except in rare situations where there is a serious risk of harm to yourself or others. Your information is collected solely for our coaching work, is not shared with anyone else, and can be deleted at your request. There are no right or wrong answers — just what feels true for you. Thank you for taking the time to share and for taking this important first step.

*Confidentiality exceptions apply only if you disclose that you intend to commit a future crime, if there is serious risk of harm to yourself or others, or if I am legally required to comply with a subpoena or court order. Your privacy is deeply respected.

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(1 = Just exploring, 10 = Fully committed and ready to grow.)