Dr Lurve Individual Intake Form

To get the most out of each coaching session, please take a moment to consider the following questions prior to our session. It will help guide our session for maximum impact.

Please take a moment to consider how you want to use your time with me. I invite you to be open and honest in your answers as we endeavor to unpack the issues that are affecting you right now!

I promise to be honest, open, and raw through our call, I ask kindly for the same in return. It’s the only way we will get some really great results.

Some of our conversations might feel challenging and uncomfortable, I ask that you sit through it. It's in these times we discover our gold nuggets.

I always expect that my clients leave the session with clarity, some direction, and occasionally tasks for you to complete in order to work through your current situation.

I am passionate about helping you get through your challenges in life, your relationships & of curse love.

I look forward to helping you!

Dr. Lurve

Name

First Name

Last Name

What are your challenges right now?

Out of these challenges, what do you want to focus on in your Relationship Advice Call with Dr Lurve?

How much do you want to get past this challenge? On a scale of 1 - 10, with 1 being not important and 10 being very important, where do you sit on the scale?

Have you ever had help/coaching/therapy to help with this challenge?

What areas of your life have been affected by this challenge?

Are you ready to do something about it now? Or are you happy to continue life with the problem?

What would your ideal outcome be after coaching? (What do you want?)

Do you have children? How many, how old and what are their names?

Is there anything that could get in the way of you getting the results you want?

Have you been diagnosed with a mental health disorder? Are you medicated?

Is there anything else you think I should know before we embark on our coaching journey?