Find a Life Coach New Client FormClient InformationName*FirstLastHome or Work PhoneCell Phone*AddressCityStateZipAge*Email address*Referred byWork InformationOccupationYour responsibilitiesAdditional InformationHow would you describe yourself?Describe your relationship.Have you ever had counseling?YesNoHow did it help?Physical illnesses or injury (describe)?Are you taking any medication (describe)?How would you like your life to be different in each of the following areas?WorkRelationshipRelationshipHealthSpiritualFirst Session Guarantee If for any reason you are dissatisfied with your initial session let me know and there will be no charge.Informed Consent Agreement I understand that coaching, or counseling, sessions or workshops are for educational purposes and are not psychotherapy or a substitute for psychotherapy. Coaching differs from psychotherapy in that therapy typically focuses on illness or the effects of trauma while coaching focuses on the enhancement of achievement and fulfillment in a person. I also understand that this work will likely bring about deep emotional and mental change. In consideration for participation in coaching, or counseling, sessions I assume full responsibility for myself (and/or for my children) during any work – and for all the results of this work – and hereby release all Life Coach Austin Coaches and any other involved parties from any and all liability and from any failure due to negligence. I agree that I have read this entire statement. I also agree to provide 24 hours notice if canceling or rescheduling a session.Signature*Signed*I agreeBy checking this box I agree to the above mentioned consent details.Date*SendThis field should be left blank