Client Intake & Informed Consent Form

WOLF COACHING

Client Intake & Informed Consent Form

Thank you for choosing Wolf Coaching PTY LTD.

This form helps us understand your goals, challenges, and expectations so that we can make the most of our time together. Please answer as honestly as possible. There are no right or wrong answers.

All information provided will be treated confidentially in accordance with our Coaching Agreement and Privacy Policy.

Client Intake & Informed Consent Form

SECTION 1: PERSONAL DETAILS

Full Name:

Preferred Name:

Date of Birth:

Email Address:

Mobile Number:

Country / Time Zone:

Occupation / Business:

SECTION 2: EMERGENCY CONTACT

Emergency Contact Name:

Relationship:

Contact Number:

SECTION 3: YOUR COACHING GOALS

What inspired you to seek coaching at this point in your life?

What would you most like to achieve through coaching?

What would success look like for you?

If our coaching together was highly successful, what would be different in your life six months from now?

SECTION 4: CURRENT CHALLENGES

What challenges, frustrations, or obstacles are you currently facing?

What do you feel is keeping you stuck?

Which areas of your life would you most like to improve?

Confidence

Self-Esteem

Relationships

Communication

Career

Business

Finances

Purpose & Direction

Motivation

Stress Management

Emotional Resilience

Work-Life Balance

Health & Wellbeing

Goal Achievement

Personal Growth

Other

SECTION 5: SELF-ASSESSMENT

On a scale of 1–10, how satisfied are you with the following areas of your life?

Area

Score (1–10)

Personal Growth

Confidence

Relationships

Career or Business

Finances

Physical Health

Emotional Wellbeing

Work-Life Balance

Overall Life Satisfaction

SECTION 6: PREVIOUS EXPERIENCE

Have you worked with a coach before?

Yes

If yes, please describe your experience:

Have you attended any personal development, NLP, mindset, or leadership programmes?

Yes

If yes, please tell us more:

SECTION 7: SUPPORT SYSTEMS

Who are the key people supporting you in your life?

What strengths do you believe you bring to the coaching process?

SECTION 8: COMMITMENT TO CHANGE

Statement

Rating (1-10)

I am committed to making positive changes.

I am willing to be honest with myself.

I am open to trying new approaches.

I am willing to take responsibility for my actions.

I am ready to invest time and effort into my growth.

SECTION 9: COACHING PREFERENCES

How do you learn best?

Discussion

Reflection

Practical Exercises

Written Activities

Visualisation

Accountability

Structured Plans

Other:

What would make this coaching experience most valuable for you?

SECTION 10: IMPORTANT INFORMATION

Are there any circumstances, challenges, or concerns that you would like your coach to be aware of before coaching begins?

INFORMED CONSENT

Please read the statements below carefully.

I acknowledge that:

I understand that coaching is not therapy, counselling, psychology, psychiatry, medical treatment, legal advice, or financial advice.

I understand that I am fully responsible for my decisions, actions, and outcomes.

I understand that coaching outcomes cannot be guaranteed.

I understand that coaching may include personal development exercises, mindset work, NLP techniques, reflective exercises, goal-setting activities, and behavioural change strategies.

I understand that I may decline any exercise or activity at any time.

I have had the opportunity to ask questions regarding the coaching process.

I understand that information shared during coaching will be treated confidentially subject to the limitations outlined in the Coaching Agreement.

I consent to participate in coaching services provided by Wolf Coaching PTY LTD.

COMMUNICATION CONSENT

Please indicate your preferences.

I consent to receiving appointment reminders.

I consent to receiving coaching-related communications.

I consent to receiving newsletters, articles, updates, and marketing communications from Wolf Coaching PTY LTD.

I understand that I may unsubscribe from marketing communications at any time.

POPIA CONSENT

I consent to Wolf Coaching PTY LTD collecting, storing, and processing my personal information for the purposes of providing coaching services, communicating with me, maintaining client records, and fulfilling legal obligations in accordance with applicable privacy laws and the Wolf Coaching Privacy Policy.

I Agree

CLIENT DECLARATION

I confirm that the information provided in this form is accurate to the best of my knowledge.

Client Name:

Signature:

Sign Here

Date:

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