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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 that you take a quiz on high sensitivity before we start working together, at least for you and your child. This is preferable for all members of the family. I have compiled a selection of the best quizzes here. However, if you prefer, we can do one in our first coaching session.

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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.

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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.

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I look forward to meeting you. 

Intake Form for a parent of a HSC

Client Contact Information

Date of birth of parent
Day
Month
Year
Choose your preferred coaching
Individual Coaching
Parents Coaching
Family Coaching
Child Coaching

To check the differnece between this packages go here

Information about the highly sensitive child

Gender of the child?
Male
Female
Prefer not to say
Other
Did You do any quiz on high sensitivity of the child?
yes
no

Questions related to the reasons 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
no

Next steps

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

«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.

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