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Intake and Consultation Form

Thank you so much for deciding to go ahead with the Coaching Programme.

I am delighted to be working with you to help you achieve your transformational goals. 

To find out more about you and to help clarify what you would like to work on during our time together, please complete this form with some of your personal information. The information you provide will tell me a little about you, your lifestyle, what you want to achieve and what is holding you back, and it will help us to tailor the coaching programme to meet your needs and desired outcomes. Please answer the questions honestly and to the best of your ability, and note that all the information you provide is completely confidential.


Privacy, Confidentiality and Data Protection

To protect your privacy, all client data is kept strictly confidential and will be stored in accordance with the General Data Protection Regulation (GDPR)/applicable Data Privacy laws.  All information is completely confidential always, unless permission is given otherwise. Please read our Privacy Policy and note that by agreeing to this section, you consent that the Coach may release information to a relevant individual or agency if it has been determined that a child or adult is at risk of or is currently being abused; or if you as a client are an imminent danger to yourself or others; or if a subpoena of records or any other requirement to share information by law has been requested.  

Terms and Conditions of Service

The Terms and Conditions of Service contain important information regarding limitations of liability, guarantees, representations or warranties of any kind, express or implied, with respect to the coaching services negotiated, agreed upon and rendered. Please read the Terms and Conditions and confirm that you agree to them.

Declaration

The information I have given here is, to the best of my knowledge, full and correct. I undertake the Coaching Programme on the understanding that it is a collaborative process and that progress and success are dependent upon my motivation and participation.