ONLINE COACHING SESSIONS WITH WHERE THE MIND GROWS

CLIENT REGISTRATION

Coaching Registration form

(Self-Fund/Employer Funded)

Personal Information - About You

First name

Last name

Preferred name (if different)

Phone: Used for WhatsApp/Text Message contact with JK as required.

Address

Preferred Pronoun

Birthday

Day

Month

Year

Company name (For EMPLOYER FUNDED ONLY)

Position/Job Role/Occupation

Emergency Contact - Name/Number and relationship to you. This person would only be contacted in an emergency relating to yourself. In the context of our coaching.

Coaching Together

What is your expectation or understanding of coaching together?

What is the challenge/issue or goal you want to explore in coaching sessions?

How would you like things to be different?

What stops things changing/makes things worse?

What would be a great outcome/outcomes for you?

Is there anything else you would like to share with me about your situation? (This might be a bit about you or a wider focus or information you feel could be relevant for me to be aware of)

Have you accessed any other therapeutic or coaching services in the past/currently?

Yes

If so, was it helpful and how/how not?

Please disclose any medical or health conditions or issues (past or current)

Any accessibility needs?

How would you describe your learning and communication style and needs?

Any questions before we begin coaching?

I understand that by completing this form I consent to you storing my data for the purpose of coaching records and service.

You have read and understand the coaching agreement and terms explained.

Yes, please subscribe me to your newsletter. Please tick this if you would like to receive my twice weekly email newsletter/blog.

Signature

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Please complete this form honestly and openly. It comes direct to me (JK) and supports our preparation and coaching work together. If at any point you need to update your information, please email me to let me know. infor@wherethemindgrows.co.uk. This form should be completed a minimum of two working days prior to your initial session - thank you and I look forward to coaching together.

Coaching Agreement

Read the coaching agreement here

Our coaching agreement outlines how we will work together in the coaching relationship and some practical terms and conditions.

(Please note if completing this form for employer funded sessions its likely the payment terms will sit with your employer_

Coaching Agreement

Coaching Packages
[Booking Links]

INITIAL SESSION (6 PKG)

ONGOING SESSIONS

If your employer is funding these sessions, please use the ongoing sessions button to bi-pass payment and book in.

For self funded sessions, please note payment is required up front on selecting your package.

CLIENT REGISTRATION

Coaching Registration form

(Self-Fund/Employer Funded)

Personal Information - About You

Coaching Together

Coaching Agreement

Coaching Packages [Booking Links]

Coaching Packages
[Booking Links]