NLP Coaching All journeys begin with the very first step. New Client Details & Coaching Agreement Personal Details Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone Number * Email * Date of Birth * Marital Status Occupation * Thank you for choosing to work with me to make some powerful and insightful changes in your life! To begin the process please take a few moments to answer the following questions and read the coaching agreement below. Personal History What are you looking for coaching on? * When did your issue/symptoms begin? How is this issue currently affecting your life? * Do you believe it's possible to resolve your issues? * Yes No Maybe What do you hope to achieve and what would be a great result for you? * What would you love to be able to do in your life, that you aren't currently? * How committed are you to creating that result? * What do you believe might be preventing you from moving forward right now? For you to be coaching most effectively, what do I need to know about you? To help me assess your suitability for NLP Coaching please tell me if you have any medical or mental health issues that you have not yet mentioned on this form. If so, please list them: * Coaching Agreement & Expectations What is NLP Coaching? There are many definitions of coaching. For me it’s about helping you get unstuck by working out what is getting in your way, so you can move forward and live to your full potential. Coaching is a powerful conversation that inspires you to create that life you love. Many coaches are great at goal setting, action plans, inspiring and supporting but don’t have the skill set to deal with ‘why’ people get in their own way, and what do to change that. This is a key distinction with the work of NLP (Neuro Linguistic Programming). In my work I use a combination of NLP, hypnotherapy and coaching to help my clients get unstuck and make great change in their lives. Responsibility My job as a coach is to support and empower you to attain the results you desire. Your job as a client is to show up on time and be ready to make change. It’s also important to follow through on any commitments you make during our time together, should we set any tasks to complete in between coaching sessions. Payment Details My standard coaching fee is $290 for an initial 90 min consult and $245 per hour thereafter. There is the option for a package of 4 coaching sessions for $840. Payment terms are same day and payable as direct deposit or by cash. Cancellation If you need to change or cancel an appointment, please provide 48 hours notice so I may fill this session to help another client. Should you need to reschedule, please email me. Confidentiality Our work is completely confidential and anything you say will say ‘within the room’. I aim to work with my clients with the upmost care and integrity. The only reason to disclose any personal information would be in the rare circumstance where this was required by law or where disclosing information is necessary to prevent a serious crime or serious harm to other people. Online Sessions By completing this form, you are agreeing that you are happy to use a third-party software package (Zoom) to participate in online coaching sessions. Emergency Contact * So that we can contact someone close to you in the case of an emergency please provide the following contact details: First Name Last Name Emergency Contact Phone Number * Coaching Agreement * I have read and agree to the information above. Please use initials to represent your signature: * Date * DD/MM/YYYY Woo hoo, all done! Let's get started! Thank you for completing this form.Please book in your initial 1.5 h coaching session here.I look forward to speaking with you soon!
