STORYWORK INTAKE FORM Name Email * Time zone or location To facilitate the therapeutic process, it is generally advised to establish a regular meeting time. What days and times work best of you, and/or any days/times that don't work for you? What story do you want to tell? What are your top three goals or aspirations you are seeking to actualise by working together? this can be in the area of your physical, mental, energetic, relational, occupational health? What challenges, 'blocks' or obstacles have you encountered in pursuing these goals? What recurring patterns or behaviors do you notice that hinder your personal growth or spiritual development? Have you worked with a therapist or coach before? If so what form of support did you receive, how was it for you? What are your expectations from the coaching process? What qualities or characteristics are you looking for in a life coach? Do you currently experience any chronic health conditions or symptoms or have in the past; for ex. digestive issues, physical pain, hormonal dysregulation? Have you received a formal psychological diagnosis in the past? Do you engage in or are you apart of any practices or communities to support your emotional/spiritual life? Do you meditate? Is there anything else you would like me to know? Thank you!