Welcome! This short intake form will help us understand where you are on your journey and if coaching with the BEING framework is the right fit for you.

Section 1: Basic Information

Full Name

Email *

Phone *

Current Profession / Role:

Section 2: Where You Are Now

On a scale of 1–10, how confident do you feel in your professional role?

What are your biggest challenges right now? (check all that apply)

When faced with challenges, what do you usually do?

Push through on my own

Ask colleagues for help

Research / read guidelines or policies

Avoid / procrastinate

Section 3: Where You Want to Be

If you could change ONE thing about your professional or personal life right now, what would it be?

Which of these outcomes would be most valuable for you? (rank your top 3)

Believe in myself and my skills

Feel empowered to make decisions

Ignite my motivation and passion

Never give up when things get hard

Grow in my role and leadership

On a scale of 1–10, how ready are you to invest time and energy into your growth?

Section 4: Coaching Interest

Have you ever worked with a life or professional coach before?

Yes

No

What kind of support would be most helpful for you right now?

One-on-one coaching

Group coaching / community

Tools, worksheets, and self-study

A mix of all the above

What interests you about being coached through the BEINGedge™ framework

Section 5: Next Steps

Would you like to schedule a complimentary discovery call to explore if coaching is right for you?