Intake Form - Coaching | Diana Schnitzler

Personal Information

First Name *

Last Name *

Age

Email Address *

Phone Number *

Coaching Package

Client Pool Coaching - 3 Sessions (free)

Please take a few minutes to answer the following questions thoughtfully.

Current Situation

What motivated you to seek coaching right now? *

Which aspects of your life currently give you energy and which drain your energy? *

What do you consider to be your greatest strength(s)? *

If you have already received therapeutic treatment for any of the following topics: bipolar disorder/manic depression; post-traumatic stress disorder; clinical depression; eating disorders; and/or suicide attempts, please address this in our first session so we can determine together whether coaching is right for you at this time.

Coaching

Which topics would you like to explore during our time together?
Topic 1 *

Topic 2

Topic 3

What have you done so far to approach these topics? *

Collaboration

What is your preferred schedule for our coaching sessions (time of day, frequency, duration) and what obligations/constraints should be considered? *

What can I do to make you feel safe and supported in our work together? *

Your commitment: How much time between sessions are you willing to invest (e.g., in exercises, preparation/follow-up)? *

Other

Is there anything else you would like me to know?

Thank you for your time and openness!