A warm welcome to you! You've just taken a courageous step by committing to this mind-body work. In doing so, you will begin to make significant shifts in your life path. I'm here to support you in this whole process so that you can start to heal your body, mind, and soul. And, as with all of my clients, I genuinely want to see you thrive and enjoy life more than you ever have before!

Please know that it's perfectly normal at times to have a down week and even feel uncomfortable about the new things that you are creating in your life. Change can be unsettling at times, but it's in pushing ourselves to overcome these obstacles that we see possibility and results. You and I will be busting through all the inner limits on the way to your own North Star.

As your coach, I will be your biggest champion and wellness mentor, but I will also challenge you if you need it. Ultimately I do believe that you know yourself best, so if something isn't working for you, I always recommend that you are open and honest with me. Coaching is about finding the solutions that work for you. I am honored to be on this journey with you.


As we begin, I must get a sense of how you view the world and yourself. Each person has his/her unique ways of perceiving and has a unique way of interacting with others.

The following questions are to help me get to know you better. They are designed to stimulate your thinking such that our time together will be as productive as possible. I suggest you ponder the questions for a few days as you compose your responses and keep in mind that there are no right or wrong answers, just whatever is true for you.

Please take all the space you need to respond thoughtfully and submit this form to me at least 24 hours before our first session.

*I recommend that you compose your answers in a separate online document or handwrite them and then input into this form. The website does not auto-save, and you could lose your work if you attempt to fill it out over time.

Name *
What are the biggest goals you want to achieve in the next 3-6 months?
What are some key lifestyle changes you would like to implement/achieve? You may not have ideas about this right now, and that's okay.
We humans have learned to tolerate a variety of situations, behaviors in relationships (in ourselves and others), frustrations, unmet needs, lowered standards, and so on. Things that you put up with drain energy and divert focus from purpose. This could be in your physical environment (your brother losing his temper), your school environment (lack of free time), or your relationships with family and friends (not being understood). What are you tolerating? Please take some time to write down the things that you are putting up with. Simply becoming aware of what you are tolerating will bring these parts of your life into the forefront and you will naturally begin resolving them. Discuss these with me. Let’s make sure that part of our overall plan includes how to eliminate or learn to manage these energy drains.
If there were no obstacles in the way, what dream would you like to make happen?
Think about one or two people you know (or know of) who inspire you. What about them is inspiring?
When you were a child, were there any activities that were so interesting to you that they could cause you to lose track of time (you had to be reminded to come home for dinner, go to bed etc.)? Please tell me about them.
What two steps could you take immediately that would make the biggest difference in your current situation? (Your health situation or area of least satisfaction in your life in general)
How have you been motivated in the past to reach difficult goals, make difficult decisions, or do challenging things? How can we best utilize that motivator now?
Are there any activities in which you now participate (as a young adult) that cause you to lose track of time? Please tell me about them.
If you could break any rule without consequences, what rule would you break?
What is your body saying no to?
Why do you BELIEVE you're unwell or stuck right now?
What does your body need in order to heal? (You do not need to answer this question if you feel that your physical health is optimal.)
What do I need to know about you that will help me most in coaching you?