One-to-one session booking

Taster session questionnaire

Thank you for your interest in Body~Mind Coaching. This initial consultation is done online and lasts approximately 90min. It is designed for you to experience the way I work and help us both decide whether I am the right person to help you. You will be able to ask me questions to alleviate any concerns, before committing valuable time, energy and money to your healing process. If after this consultation we can work together, we will discuss the best way forward. This is offered in exchange for a donation to the ‘Freedom Kit bag charity’ I support. (Payment details will be sent after your appointment) To maximise the value of our time together, please answer the questions below. This is not a test; there are no right or wrong answers.

Name(Required)

First Last

Email(Required)

Phone

Address

Street Address City County / State / Region ZIP / Postal Code Country

Emergency contact No: …. Name and what relation they are to you:

1. How did you find out about me?

2. What do you need help with?

3. How long has this been a problem?

4. How does this affect your life?

5. On a Scale from 0 = not at all to 10 = absolutely, how willing are you to invest -financially and emotionally – in your transformation?

6. What are you hoping for?

7. What do you think might get in the way of you overcoming your problem(s)?

8. What do you want to explore most in the taster session?

9. What makes you think I can help you?

10. What help would you like from me?

11. If I had a magic wand and there was one thing about you that could be different what would it be?

12. Are you currently working with or scheduled to work with any other healthcare professional(s)?

13. How would your life be different if this matter was resolved?

14. Is there anything else you would like to share with me or feel I should know about?

15. Do you have a budget in mind, to resolve this issue?

Thank you. Please submit your answers and I’ll be in touch with possible appointment dates and times.