Coaching Inquiry

Ready for Change?

I work with people who are ready, intent, and likely to benefit from my services. Complete this form, and I will call you soon.

Name

First Name

Last Name

Email

Subject

Message

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Life Phase

Under 18

18-24

25-34

35-44

45-54

55-64

65 or Above

Prefer Not To Answer

How do you spend your days, and do you enjoy what you do?

Tell me about your goals for your immediate future, if you have them.

What is currently the biggest stressor or challenge in your life?

Is this something new, or has it been a long-term situation? Please explain.

What would you like coaching to help you accomplish?

It's okay if it sounds impossible. We will work together to see what can be improved.

Try some of the online self-coaching tools on the Coaching and Leadership International website. They are free to use.

I recommend "The Brain Walk® - a Journey for Peace of Mind" - also available as an iPad app download.