Wellness Coaching Consultation Form (Copy)

Wellness Coaching Exploratory Call and Introductory Session Intake Form

If you have already scheduled a wellness coaching exploratory call / introductory session with me, please complete this form at least 24 hours in advance of the session.

Name

First Name

Last Name

Phone

Country

(###)

###

####

On a scale of 1 to 10 (1 is extremely dissatisfied and 10 is extremely satisfied), how would you rate your current satisfaction with your overall wellness?

Thinking on a more specific level, on a scale of 1 to 10, how would you rate your current satisfaction with your physical wellness (body)?

Thinking on a more specific level, on a scale of 1 to 10, how would you rate your current satisfaction with your mental wellness (mind)?

Thinking on a more specific level, on a scale of 1 to 10, how would you rate your current satisfaction with your spiritual wellness (spirit)?

What makes you the happiest in your life currently?

What would you most like to change or improve regarding your overall wellness or life and why?

Date of your session

YYYY

Time of your session

Hour

Minute

Second

Wellness Coaching Exploratory Call and Introductory Session Intake Form

Whole Wellness Journey LLC