Intake Form Adult | Sensitive Coaching Practice

read carefully before filling out the form

This intake form is designed to help us start our coaching journey together in the most effective and productive way possible, while also tailoring it to your needs. I highly recommend taking a quiz on high sensitivity before we start working together. I have compiled a selection of the best quizzes here. However, if you prefer, we can do one in our first coaching session.

Your personal data will be processed in accordance with the General Data Protection Regulation (GDPR – Regulation (EU) 2016/679) and the German Federal Data Protection Act (BDSG). We implement technical and organizational measures (TOMs) according to Art. 32 GDPR to protect Your Data. By using the service, You agree to the collection and use of information in accordance with this Privacy Policy.

Note: No transmission over the internet is 100% secure.

If you would prefer, you can download this form as a PDF to your computer, fill it out and send it to me by email.

I will not use your data to automatically subscribe you to a newsletter or send you any other advertisements. If you would like to subscribe to my newsletter, please complete the Subscribe to a newsletter form.

I look forward to meeting you.

Intake Form for an adult

Client Contact Information

Name

Date of birth

Day

Month

Year

Nationality

Location

Occupation

Contact number

Questions related to the reasons for Coaching

Reasons for coaching

Goals for coaching

Preferred duration of coaching session

60 min

90 min

120 min

other

Client information

Did You do any quiz on high sensitivity?

yes

I am not highly sensitive, I want a sensitive coaching approach

What is Your family situation

What is Your relationship status

Are You receiving any other type of therapy/medical intervention that I need to know about?

How would You describe your physical health?

How would You describe your current mental/emotional state?

Are You on any medication that is important for me to know about?

What social supports do You have?

Is there anything specific related to Your history, or current general mental, emotional or physical health that I need to know in regard to us working together?

Do You have any specific spiritual/religious beliefs?

Next steps

What is the best way for us to conduct the call?

Phone? Whatsapp? Signal? What time suits you best?

When is the best time for sessions?

Where did You find out about Sensitive Coaching Practice?

I confirm that I have voluntarily and in full awareness provided accurate information about myself.

We process Your Personal Data in accordance with the General Data Protection Regulation (GDPR – Regulation (EU) 2016/679) and the German Federal Data Protection Act (BDSG).

By using the Service, You agree to the collection and use of information in accordance with our Privacy Policy.

«Even a little time with the right person can make all the difference»

Dr. Elaine N. Aron,

clinical research psychologist of the High Sensitivity Trait.