Worksheet

Consultation for Private Emotional Literacy Instruction/Coaching

Thank you for taking the time to fill out this consultation form. Your responses will help me better understand your needs and tailor our sessions to meet your goals effectively.

1.

Full name:

2.

Contact information (phone/email)


3.

Preferred Pronouns:

4.

Are you seeking individual coaching or planning to attend as part of a group or with a partner?

5.

If you chose 'other', please specify here:

6.

What specific areas in your life are you looking to improve through emotional literacy coaching and instruction? Check all that apply.

7.

If you chose 'other', please specify here:

8.

Please briefly describe your main goals or challenges related to emotional literacy that you hope to address in these coaching sessions:

9.

Have you had any prior experience with emotional literacy training or coaching? If yes, please provide some details:

10.

Is there any additional information or specific expectations you'd like to share about these coaching sessions?

11.

All sessions will be conducted online via Zoom unless otherwise arranged. What days and times would you prefer to meet for sessions? Please provide multiple options.

12.

How did you hear about our emotional literacy coaching services?

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