Therapeutic Life Coaching

Therapeutic life coaching offers a comprehensive healing and empowering journey that is customized and action oriented to address all areas of your wellness and life: mental, emotional, physical, professional, spiritual, relational, recreational, sexual and financial. Of course there are therapeutic aspects woven into and throughout your journey depending on your needs and goals. We will identify your strengths and challenges that either hinder or support your wellness goals in each of these equally important areas of your life.

Though my gifts as a compassionate and intuitive healer and licensed psychotherapist are front and center during our time together; my role as your coach also allows for accountability, connection in between sessions and personalized weekly exercises and practices to keep you inspired and progressing.

I have found that traditional therapy models of treatment can be limiting as action and ownership of your valuable goals and choices are absolutely necessary to heal and grow in a deep and lasting way. Serving as your therapeutic life coach also allows you and me the priceless freedom in our wellness partnership that therapy standards of practice and health insurance companies do not permit. Sometimes participants of psychotherapy (both client and therapist) can slip into being problem focused rather than solution focused. True healing comes from your commitment to your process of self actualization, the development of a genuine sense of self respect as well as the experience of empowerment created by daily use of your strengths and resources while you heal thought and behavior patterns/habits that interfere with your feelings of contentment, fulfillment, purpose, joy and peace.

My therapeutic life coaching approach is for individuals who are ready for commitment and are willing to surrender to the process. You will be completing holistic exercises and investing in your wellness demonstrated by your follow through actions and mindfulness practices in between every session. Do not be afraid! It's progress, not perfection! We will design your program based on very reasonable and balanced goals each week.

We will work on deepening your understanding of yourself and others through your personal spiritual lens with a strong focus on forgiving and loving yourself and others. You will develop lifelong skills and practices that will continue to support your ongoing growth and fulfillment. Our goal for each and every session is that you will leave with a sense of clarity, healing, progress and purpose.

I consider it a profound honor to walk along side you as you embark on this quest for wholeness! Let's go!

Therapeutic Coaching Intake

Basic Information...about you
Date*
Name*
Telephone*
Email Address*
Gender*
- Select All
- Male
- Female
Relationship Status*
- Single
- Married
- Divorced
- Widowed
Street Address*
Address Line 2
City*
State*
Zip Code*
Date of Birth*
Emergency Contact Name*
Emergency Contact Phone Number*
Emergency Contact Address*
Wellness Assessment...how are you?
Allow me to get to know you. Please take your time to respond thoughtfully. After all, you matter! Don't you? Let's get started! If there are any questions you prefer not to answer please reply with N/A
Professional Wellness
How do you rate your professional intelligence? 0-10*

Professional Intelligence: the ability to acquire and apply knowledge related to your occupation
In what ways do you demonstrate professional intelligence?*
What are your related habits/practices
How do you rate your overall sense of professional well being? 0-10*
Occupation*
What do you do? How long? Name of employer?
Occupation Fullfillment (please be brief but thorough; address all areas listed)*
What do you enjoy about your occupation? Co-workers? Employer? Location? Compensation? Environment? Tasks/Duties? Schedule? Work-life Balance? Level of challenge/growth opportunities? Benefits?
Please list what you would change about your occupational circumstances.*
Describe your professional goals?*
Describe your professional growing edges, challenges and weakenesses
Describe your professional strengths, skills and talents
Physical Wellness
How do you rate your physical intelligence? 0-10*

Physical Intelligence: the ability to acquire and apply knowledge related to your physical health and vitality
In what ways do you demonstrate physical intelligence*
What are your related habits/practices
How do you rate your overall sense of physical well being? 0-10*
Do you exercise? What forms? How often and how much? Do you enjoy it?*
Are you happy with your current weight and body shape? Why or why not?*
Describe your daily nutrition/diet*
List your prescribed medications, dosage and when you take them*
Please note name of prescribing doctor
List your supplements, dosage and when you take them*
Include brands that you use and who recommended them to you
Describe your sleep patterns*
How much, do you remember dreams, do you fall asleep easily, do you wake during the night, how often, do your use sleep aids?
List all kind of beverages you drink and how much daily*
Water, alcohol, soda, caffeine, juice
List all non-prescribed drugs used, how often and how much*
List forms of physical recreation that you enjoy and how often*
Are you being or have you been treated for any medical conditions?*
Please list past conditions, treatment and providers Please list current conditions, treatment and providers
Relational Wellness
How do you rate your relational intelligence? 0-10*

Relational Intelligence: the ability to acquire and apply skills related to authentic communication and fulfilling connection
How do you rate your overall sense of relational well being? 0-10*
List names and relationship of important people in your life*
Family, friends, co-workers, mentors
Who of your connections do you turn to for support and why?*
Do you consider yourself a trusting person?*
Do you consider yourself a forgiving person?*
Which of your relationships do you find most challenging and why?*
How would you describe your relationship with yourself?*
Do you have pets? If so list types and names*
Sexual Wellness
How do you rate your sexual intelligence? 0-10*

Sexual Intelligence: the ability to acquire and apply knowledge related to your sense of sexual comfortability, communication and fulfillment
How do you rate your overall sense of sexual well being? 0-10*

Comfortability communicating with partner/s, satisfaction with intimacy, satisfaction with pleasure experience, satisfaction with trust, satisfaction with sense of safety
Are you satisfied with your level of sex drive?*
Do you consider your sex life to be a contributing factor in your health?*
Are you currently sexually active?*
Are you in a committed monogamous relationship?*
Do you have multiple partners?*
What would you change about your sex life?*
Emotional Wellness
How do you rate your emotional intelligence? 0-10*

Emotional Intelligence: the ability to acquire and apply knowledge related to identifying, processing/feeling and sharing your emotions
How do you rate your overall sense of emotional well being? 0-10*
Do you struggle with managing your emotions?*
Frequent shifting of emotions? flooding? highs and lows? self judgment of your emotions? avoid or numb emotions?
Do you consider emotional vulnerability to be a contributing factor in your overall health? Why or why not?*
Have you experienced significant traumas that i should know about?*
Please list briefly
Do you consider yourself empathetic?*
Mental Wellness
How do you rate your mental intelligence? 0-10*

Mental intelligence: the ability to acquire and apply knowledge related to thought management, problem solving, mental stimulation, memory and processing information
How do you rate your overall sense of mental well being? 0-10*
Do you struggle with any kind of mental illness? Please describe*
Anxiety, depression, addiction issues, OCD, PTSD, racing thoughts, ADD, etc.
Have you been or are you being treated for any mental illness?*
Please note kind of treatment and provider name
Spiritual Wellness
How do you rate your spiritual intelligence? 0-10*

Spiritual intelligence: the ability to acquire and apply knowledge related to your personal spirituality and awareness that leads to a sense of fulfillment and purpose
How do you rate your overall spiritual wellness? 0-10*
Do you follow a particular spiritual path?*
Do you belong to or participate in a spiritual community? If so, describe*
Do you feel spiritually fulfilled and connected? Why or why not?*
How would you describe your spiritual beliefs?*
Financial Wellness
How do you rate your financial intelligence? 0-10*

Financial intelligence: the ability to acquire and apply knowledge related to creating financial security and financial management
How do you rate your overall sense of financial al well being? 0-10*
Do you have a budget? Describe*
What are your financial goals?*
Do you have savings set aside for emergencies? How much?*
Do you feel comfortable with your spending habits? Why or why not?*
Do you believe you are earning up to your full potential? Why or why not?*
Do you have debt?*
Describe creditors and how much
Recreational Wellness
How do you rate your recreational intelligence? 0-10*

Recreational intelligence: the ability to acquire and apply knowledge related to engaging in play, fun, relaxation and entertainment
How do you rate your overall recreational wellness? 0-10*

Do you get enough?
What do you enjoy doing recreationally?*
List all things you consider to be recreational.
How much time do you spend watching television daily?*
Describe how you feel after watching television*
How much time do you spend on social media daily?*
Describe how you feel after being on social media*
How much time do you spend gaming daily?*
Describe how you feel after gaming?*
Need you say more....
What else would you like to share about yourself?*
Why are you ready to embark on this adventure now?*
How would you describe your wellness goals?*
What do you expect from me as your coach?*
Don't hold back. Let me hear you.
Thank you for your time, trust and honesty!
I so look forward to our journey together and helping you to achieve your optimal wellness!

Save and Continue Later

Therapeutic Life Coaching

Therapeutic Coaching Intake

Basic Information...about you

Wellness Assessment...how are you?

Professional Wellness

Physical Wellness

Relational Wellness

Sexual Wellness

Emotional Wellness

Mental Wellness

Spiritual Wellness

Financial Wellness

Recreational Wellness

Need you say more....

Thank you for your time, trust and honesty!