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Start Your Emotionology Journey

Emotionology Life – Client Onboarding & Coaching Agreement

Welcome! This form is your first step into our coaching journey together.
It includes our Client Privacy & Coaching Agreement and your onboarding intake.
Your information is secure and will be used only for coaching purposes.
Please read each section carefully and complete all required fields to proceed.  
Step 1 of 12 – Confidentiality & Data Protection
-All personal information you share will remain confidential.
-Your data will only be used for coaching purposes.
-Confidentiality may be broken only if required by law or if there is imminent risk of harm to you or others.

I have read and understand the Confidentiality & Data Protection terms.  

I have read and understand the Confidentiality & Data Protection terms.  
Step 2 of 12 – Non‑Therapy Disclaimer -Coaching is not therapy, counseling, or medical treatment.
-If higher-level support is needed, you may be referred to a licensed professional.
-By agreeing, you acknowledge that you understand the distinction between coaching and therapy.

I acknowledge that coaching is not therapy and I understand this distinction.

I acknowledge that coaching is not therapy and I understand this distinction.
Step 3 of 12 – Service Commitment & Early Termination
-Standard coaching engagement is six weeks (approximately one session per week).
-Progress is reviewed around week three to ensure alignment with your goals.
-If coaching is not yielding expected progress, either party may end the engagement early without penalty.
-You are responsible only for sessions completed.

I understand and agree to the Service Commitment & Early Termination policy.

I understand and agree to the Service Commitment & Early Termination policy.
Step 4 of 12 – Client Responsibilities & Consent Coaching success depends on your active participation and follow-through.
You agree to:
-Attend sessions on time
-Complete actions or reflections between sessions
-Communicate openly about challenges or changes

I understand and accept my responsibilities as a coaching client.

I understand and accept my responsibilities as a coaching client.
SECTION 2: Onboarding Intake
Step 5 of 12 – Personal Information & Emergency Contact  

Full Name 

Date of Birth (Day and Month ONLY) 

Gender

Email Address

Phone Number

Address (City, State, Zip Code - ONLY)

Emergency Contact: Name, Relationship, Phone Number

Step 6 of 12 – Background & Current Life Situation
Please share as much as you feel comfortable. This helps me tailor your coaching experience.  

1. Occupation, Education Level, Lifestyle (e.g., work hours, family situation, hobbies)

2. What are you looking for in a coaching relationship?

3. What are some of the most important things happening in your life right now?

Step 7 of 12 – Life Goals & Coaching Goals Please share as much as you feel comfortable. This helps me tailor your coaching experience.  

1. What are your short-term goals?

2. What are your long-term goals?

3. What would you like your life to look like five years from now?

4. What are your primary reasons for seeking life coaching?

5. What specific goals would you like to achieve through coaching?

6. Have you worked with a coach or therapist before? If yes, please describe your experience.

Step 8 of 12 – Strengths, Challenges & Support System
Please share as much as you feel comfortable. This helps me tailor your coaching experience.  

1. What do you consider to be your key strengths?

2. What challenges or obstacles do you feel are holding you back?

3. Who is your primary support system (family, friends, colleagues)?

4. Are there any additional resources or support you believe would be helpful for your coaching journey?

Step 9 of 12 – Self‑Care, Stressors & Triggers
Please share as much as you feel comfortable. This helps me tailor your coaching experience.  

1. How do you engage in self-care?

2. Could your self-care practice be improved?

3. What situations or factors cause you stress?

4. What are some things that “trigger” you emotionally?

5. How might you sabotage yourself as you work toward your goals?

Step 10 of 12 – Life Areas Self‑Assessment Rate your satisfaction with each area:  

Personal Well-Being

Personal Well-Being

Professional Life

Professional Life

Relationships

Relationships

Health & Wellness

Health & Wellness

Personal Growth

Personal Growth

Goal Setting

Goal Setting

Challenges & Obstacles

Challenges & Obstacles
Step 11 of 12 – Final Thoughts & Consent

Please provide any additional comments or insights about your current situation or goals.  

I consent to the collection and use of my personal information for the purpose of coaching ONLY.  

I consent to the collection and use of my personal information for the purpose of coaching ONLY.  

I understand that coaching is a partnership and requires active participation from both Coach and Client.

I understand that coaching is a partnership and requires active participation from both Coach and Client.

Electronic Signature (Typed Name)

Date