Coaching Intake Form

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Please complete the following information. Your answers are strictly confidential.
First Name(*)
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Last Name(*)
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Preferred Method of Payment(*)
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How Did You Hear About Us
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What would you like to accomplish
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What would you like to improve
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Have you ever sought assistance through coaching before
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Please describe
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Prices and Packages: For your convenience prepaid packages are available at a discount. Please select your preferred option:
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60 Minute Session(*)

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90 Minute session(*)

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Payment Policy
1. There are no contracts or minimum number of sessions.
2. Payments are made in advance of our scheduled appointment in order to reserve your preferred session time.
3. Individual sessions are billed at $75/60mins or $100/90mins.
4. A minimum 24 hrs. notice is required to transfer your session fee to your next appointment.

Cancellation Policy: 24 hr. notice is required to transfer your payment to your next appointment
Package Policy: Prepaid sessions are valid for up to two years (depending on package). Prepaid packages are non refundable.
Outcomes I am responsible for my own results
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Congratulations and Welcome to Time2Flourish Coaching! You have just taken the first steps toward your flourishing life. Click Submit to send your Intake Form.
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True forgiveness is when you can say, thank you for that experience. Oprah Winfrey