Let’s Get Acquainted

You are Worth It!

It all begins with You! You may have an idea. Maybe you want to launch a business. Maybe you want to turn a hobby into something more. Maybe you want healthy relationships. Maybe you just want Peace of Mind! Whatever your maybe is, maybe you should start now!

Gathering Information to Better Serve You!

Life of Purpose is happy to welcome you in our circle. We are excited that you chose us to help you achieve your personal goals. We want to heal the whole you not just parts of you.

After you complete this initial intake, we will text or email a personality test for you to complete which will also help us to better understand your unique self.

Once the test is submitted, we will contact you to schedule our first meeting together.

Please complete the following information to the best of your ability so that we can get started!

All information shared will remain confidential.

Click below to complete your initial intake for coaching services.

Initial Intake Form

Date

MM

DD

YYYY

Name

First Name

Last Name

Phone

(###)

###

####

Email

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth

Spouse/Partner Name (If Applicable)

Children's Name and Age (If Applicable)

Important Issues

Please briefly outline any issues you would like to deal with and what you hope to achieve in the coaching setting: List at least 3 to 5 issues so we can set realistic goals and outcomes.

Desired Start Date

Session Frequency

Payment Options

Monthly Fee

Per Session Fee

Payment Method

Cash

Credit Card

Billing Invoice (Company's Only)

Session Contact Procedure: The Client shall contact the Coach at the agreed hour. If the Client fails to make the appointment time, the Client is still responsible for the coaching fee, unless 24-hours notice was given to reschedule the call. The Coach will make every effort to reschedule with the Client.

Yes, I agree and understand the terms read

No, I do not agree with the terms read (we have the right to refuse services and refer out for further assistance)

Disclaimer: The Client is aware that the coaching relationship does not represent psychological counseling or any kind of therapy. The Client is also aware that coaching results can vary and are not guaranteed. The Client agrees that they are entering into coaching with the understanding that the Client is responsible for their own decisions and results. The Client also agrees to hold the Coach free from all liability for any actions or results for adverse situations created as a direct or indirect result of advice given by the Coach. Client initials by agreeing to disclaimer below