Relationship Coaching

Relationships can be complicated as some develop naturally, while others may take work. However, this does not mean we cannot have healthy and meaningful relationships. This coaching program is designed to focus on who you are in relationships, to identify your boundaries, values and beliefs to help cultivate healthy relationships.

Relationship Coaching Intake Form

Full Name*

Phone Number*

Area Code

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Phone Number

Email*

Address*

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code Country

Preferred Method of Contact*

Phone

Text

Available dates/times*

Occupation*

What type of relationship concerns you?*

What do you most value in relationships?*

What is your biggest concern about your relationship?*

Think of someone you consider yourself having a meaningful relationship with. In your own words describe why that relationship is so meaningful.*

Think of someone you consider yourself as having an estranged relationship with. In your own words described why the relationship is estranged.*

List 3 primary goals that you want to focus on in your relationship coachingprogram. These goals should be challenging, specific, and achievable.

Goal 1:*

I know I have succeeded when:*

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Goal 2:*

I know I have succeeded on goal 2 when:*

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Goal 3:*

I know I have succeeded on goal 3 when:*

I accept the Privacy, and Terms & Conditions of Tomlinson Coaching Group, LLC*

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