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The Edgewalker's Path- Intake Form

Welcome! You are here because you are ready to live, lead, and perform from a place of deep alignment. This is your space to slow down and clarify what matters most. This intake form is designed to help us understand where you currently are at and look at the whole person you are: Your Mind, Body and Your Energy. We will connect these to support you your goals, lifestyle, your drive and motivation as well as your nervous system. Please complete this intake before our first session together.

Full Name

Name Your Preferred to be called ( if different than above)

Date of Birth

Current Occupation

Email Address

Phone Number (optional)

Mailing Address

Current life status (single, married, divorced, common law, separated, children (ages)

Do you currently use Voxer for communication?

Do you currently use Voxer for communication?
A
B

If yes, what is your Voxer handle?

Describe your current life or performance landscape. (ie. training season, business phase, family structure etc.)

Have you ever worked with a coach, therapist, or mentor before?

Have you ever worked with a coach, therapist, or mentor before?
A
B

If YES to above, what did you find most helpful? Or not helpful.

What are 1 to 3 outcomes or shifts you'd love to experience through this journey?

How do you best process insight or guidance? Choose all that apply

How do you best process insight or guidance? Choose all that apply

How do you care for your mental and emotional energy right now? (eg., meditation, sleep, boundaries, therapy).

What is your current physical activity and training/movement routine like?

Are you currently following a nutrition or supplement regime? If yes, explain below. If no, would this be something that you're looking for support with?

When asked "what does balance in life look like to you" List up to five things that come to mind below.

Where do you most often feel restricted or resistance?(select all that apply.)

Where do you most often feel restricted or resistance?(select all that apply.)

Do you agree to the following:

This package is valid for four months from the date of purchase.

This package is valid for four months from the date of purchase.

This package is non-refundable.

This package is non-refundable.

I acknowledge that coaching is a collaborative, self responsible process and not a substitute for medical or psychological care

I acknowledge that coaching is a collaborative, self responsible process and not a substitute for medical or psychological care

I consent to email communication for scheduling and coaching support.

I consent to email communication for scheduling and coaching support.

I understand that my sessions happened bi-weekly and that there is a required 24 hours notice to reschedule my sessions

I understand that my sessions happened bi-weekly and that there is a required 24 hours notice to reschedule my sessions
A
B

Would you like to enhance your experience with any of the following? (select any of that interest to you and we will follow up in our first session together).

Would you like to enhance your experience with any of the following? (select any of that interest to you and we will follow up in our first session together).