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Initial Registry

All of our coaches are age 21 or older with diverse life experiences. We are a Spirit led, Christ based service however, we have no religious or political affiliation. Our Coaching services have an emphasis on Spiritual healing and assisting others in achieving prosperity.

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The following questions are to help match you with an available Coach. Although we are confident each of our coaches are capable of supporting any client, we try our best to match you based on your preferences. We also believe anyone can be inspired by the most unlikely people, places or things so, we ask you give our match a try regardless of initial impressions.

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We require basic information from you such as full name and contact info however, if you do not feel comfortable answering each question just let me know and we can skip it.


Client's Data:



Date Of Birth:
Month
Day
Year

In lieu of DOB, offer age or age range to enter in notes.

Gender:
Male
Female

Cultural, ethnic and/or racial background.




Coaching Service History:


Client Status:
New Client
Returning Client

Client's requested coach + how do they know them?



Client's Preference Details:


Preferred Coach Gender:
Male Coach
Female Coach
No preference

i.e. cultural background, musical, art background, etc + reason for preference.

i.e. service dog, wheelchair access, allergies, etc.

Interest in dancing, singing, traveling, etc. - You can also ask: Tell us something interesting about you/your life.

Verify client type: Fitness and/or Mindset Client required in notes.

F I T N E S S

M I N D S E T

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