Are you ready to speak with a coach about the amazing things coaching can do for you? Then we invite you to take a few moments to share some personal (and pertinent!) information about yourself. This allows us to tailor our coaching specifically to your needs, creating an ideal healing environment and allowing you to make the most of what coaching has to offer. (* = required fields)
		* Your name:
		* Your e-mail:
		Daytme phone:
		Evening phone:
		Alternate phone:
		In your own words, what you are seeking from coaching? Tell us your goal (some examples are: losing weight, learning to incorporate exercise into your life, getting job recognition, making a career change, improving your relationship with partner or spouse). Don't let this short list limit you! Please share some background information about your career, your family, things you enjoy for fun and/or relaxation (e.g. yoga, sailing, painting, running) and anything else you would like your coach to know about you. Do you generally prefer more direct or more indirect communication? Direct Indirect Do you enjoy creative activities? Writing Journaling Drawing Sculpting Making music Acting Would you like to work with a coach who incorporates creative expression into your coaching sessions? Yes No Do you prefer morning, afternoon or evening appointments? Morning Afternoon Evening No preference Would phone sessions be convenient for you? Yes No Do you have any physical challenges you'd like us to be aware of? If yes, please specify: How did you hear about the colorfullife? Please choose one: Promotional flyer Search engine Therapy site Word of mouth