Full Coaching Intake Form

Please select the age range that you fit into.

18-24

25-34

35-44

45-54

55-65

65+

Are you currently in therapy?

Yes

No

Do you prefer video calls or audio only?

Video

Audio Only

Scott's rate for being your personal coach is $175.00 USD per hour session. Can you confirm that you are ready to make this investment?

Yes

No

If you selected NO to the previous question, would you like to work with another coach?

Yes

No

Personal Coaching with Scott