About you

Full name *

Preferred name

Email *

Phone *

City and state *

Time zone *

Preferred session style *

Zoom In person Either

I confirm that I am 18 years of age or older. *

Your coaching focus

What prompted you to explore life coaching right now? *

If coaching is useful, what would you like to be different in three to six months? *

What would tell you that you are making progress? *

What you bring

What have you already tried?

What usually gets in the way when you try to make this change?

What strengths or resources could help you?

How ready do you feel to work on this right now? 7/10

What kind of coaching style helps you most?

What would make coaching worth your time?

Anything else you would like me to know before our first session?

Coaching acknowledgements

Please confirm each statement. Nothing is preselected.

Life coaching is not psychotherapy or medical care. * Coaching does not diagnose or treat mental-health conditions. * I remain responsible for my own decisions and actions. * Confidentiality is respected subject to applicable legal or safety obligations and the coaching agreement. * Electronic communications have inherent privacy limitations. * I consent to Nate receiving the information I submit. * I have reviewed the privacy policy. * I understand this service is not an emergency or crisis service. *

Need immediate help? This form is not monitored for emergencies. In the United States, call 911 for immediate danger or call/text 988 for crisis support.