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Client Intake Form

This is the first step in working together. This form allows me to understand your journey so far and how I can best accompany you through your transitions.

Time: About 10–15 minutes to complete.

Client Intake Form

This is the first step in our journey together. Please take a moment to reflect as you answer these questions; it typically takes about 10–15 minutes to complete.

What area of life currently feels most unclear or heavy (Check all that appy)
Which statement feels closest to your current season?
Which framework or practices resonate with you? (check any that appy)
Are you open to direct reflection and honest conversation, even when uncomfortable?
Yes
Mostly
Sometimes
Not sure yet
How are you sleeping lately?
Well
Inconsistent
Poorly
Exhausted most days
How would you describe your current energy level?
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Date
Month
Day
Year

Privacy and Consent

Your information is stored securely and used solely to personalize your coaching experience. Please note that North Node Local is not an emergency service. In the event of a crisis, please contact your local emergency response or professional crisis line. By submitting this form, you acknowledge you’ve read this information.

You don’t have to have everything figured out to reach out. We’ll find the footing together.

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