New Client Intake Form - Mosaic Warrior - Art | UGC

Section 1: Contact Information

Name

First Last

Cell Phone

Date of Birth

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Emergency Contact Name/Phone

Section 2: Coaching Agreement

Your Role in This Process

Holistic Coaching leads clients to their own understanding. Therefore, you will be coming to your own conclusions about where you’re heading and who you want to be. That’s what makes it so fun!

What a Holistic Coach Offers

Holistic Coaching is a partnership between the coach (me) and the client (you) where the coach supports your efforts toward a more meaningful and fulfilling life. Holistic Coaching philosophy views the entire person as an integrated WHOLE, understanding that all facets of a person’s life are inextricably intertwined. In addition to the well-known and commonly discussed elements of mind/body/spirit, other extremely important life factors are also taken into consideration in holistic coaching. These include relationships, finances, health, and work/career, etc.

What Holistic Coaching Is Not

Coaching is not counseling. Coaching is not therapy. Holistic Coaches are not clinicians, so they don’t diagnose or prescribe. They are not mental health professionals so they don’t analyze or treat. They coach which means that they support, encourage, inspire, and guide.

Please sign below and we will begin this great adventure!

Client Full Name (Print)(Required)

Client Full Name (Sign)(Required)

Date