book your intake

Name

City

Age

Phone number

Organization

Function

What are the reason(s) that you have signed up for coaching?

What are your objectives? What would you like to achieve during the coaching sessions?

Where do you work? How long do you work for this organization? What is your function? How long do you work in this position?

Do you currently have issues or unpleasant situations at work?

Have you been in coaching / therapy before?

Can you give a description of your personal situation?

Have there been important changes in your work or private situation in the last year?

Can you describe your family situation?