Appointments

Schedule an Appointment

Congratulations on making the decision to seek a life coach. Please fill out the coaching client service agreement form below and Dr. Small will contact you within 48 hours to schedule an appointment. Please review the full coaching contract below

Coaching Client Contract.pdf
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Coaching Client Service Agreement

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Where did you hear about my coaching services? *

What is your main reason for seeking coaching? *

Email *

Phone Number *

Is it okay to leave you messages on this phone? *

Yes No

Is it okay to text you regarding appointments? *

Yes No

Have you experienced coaching before? If so, how recently and what was your experience? *

What behaviors/attitudes would you like to change? Describe what that change would create for you. *

Submit

YOUR CART

Schedule an Appointment

Coaching Client Service Agreement

Free 30 minute discovery session upon request.

Hours

Telephone

Email