Coffee Break Coaching-Application

Coffee Break Coaching - Request Form

Reminder: hit the submit button at the bottom to complete your form!

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Address:

Street *

Line 2 *

City *

State *

Zip *

Question or situation you would like help with: *

Intention of this session:

A free, 30 minute Zoom coaching session designed to provide quick, effective solutions for a situation that feels stuck, unresolved, or confusing.
Increasing inner peace and reducing stress by releasing pain, fear, doubt, confusion, etc…
This is not intended to be, nor is it a replacement for, therapy.

For scheduling:
After I receive your request I will be in touch to schedule our 30 minute Zoom session. (Although the Zoom session is 30 minutes please reserve 60 minutes total so we have time to set-up and answer any questions you may have before we get started).

Once our Zoom session is scheduled you will receive a release form specifying that you are aware of, and agree to, our Zoom recording being shared publicly. This must be returned prior to our meeting.

If you have any additional questions before our session please email them to me at: [email protected].

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