Coaching Intake Form

Name
Preferred Session Format
Are these experiences connected to any of the following?
You do not need to share explicit details, only what feels relevant.
What areas of life feel most impacted by what you are integrating?
What support systems do you currently have?
Examples: clarity, grounding, embodiment, emotional processing, life alignment, meaning-making, practical integration
How would you currently describe your emotional capacity to engage in integration work?
What practices currently support your regulation or wellbeing?
Boundaries & Scope of Practice
Integration Coaching is a non-clinical, non-medical service focused on meaning-making, personal growth, embodiment, and life integration. It is not psychotherapy, medical treatment, or crisis support.
I understand that Integration Coaching is not a substitute for psychotherapy, medical care, or emergency services.
I understand that I am responsible for my own wellbeing and will seek additional support if needed.
I understand that information shared in integration coaching is held confidentially within ethical and legal limits.
I consent to participate in Integration Coaching sessions.