A.R.T Your Life Coaching ProfilePlease enable JavaScript in your browser to complete this form.Date *Name *FirstLastEmail Address *Phone *Date of Birth *DD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Residential Address *Address Line 1CityState / Province / RegionPostal CodePostal address is the same as residential addressYesPostal AddressAddress Line 1CityState / Province / RegionPostal CodeThank you for completing your coaching profile, it will help me to get to know you and assist you to get the results you are wanting from your coaching sessions. No answer is too long nor too short and there is no ‘right’ way to complete your profile. Just be you and answer from your heart.Where have you been:1. What would you say your three greatest achievements are?2. What has been the greatest challenge for you in life?3. Have you experienced any major transitions in your life in the last 2 years e.g. Work or relationships, starting new employment or professional directions, entering a new relationship, illness, moving home, childbirth, marriage, travel?4. Have you been to a counsellor or psychologist in your life and if so what was good and what wasn’t and how long ago?5. Have you experienced and or been exposed to abuse or trauma in your life?Where are you now:6. Describe a ‘normal’ day for you?7. Who are the key people in your life and what do they give you and/or why are they key?8. How would you rate the current level of stress in your life, using 10 as high and 1 as very low?9. What are the top 3 challenges in your life right now?Where are you going:10. Have you a personal or career dream/vision you aspire to? 11. In what way would you like to increase your mental, physical and emotional wellbeing?12. What changes would you like to experience in your life? How can I best coach you?13. How do you want me to be as your coach? Rank 1-6 – Place the following in order of importance (1+ Most Important and 6 = Least Important)14. Is there anything or anyone that may hinder you from achieving your outcome that would be useful for me to know?15. What are your expectations of me, your coach?16. What can I expect from you?A.R.T Your Life Coaching Participant Agreement and ReleaseTerms & Conditions *I have read, understood and agree to theA.R.T Your Life Coaching Participant Agreement and Release ×Confidentiality: Anything shared is regarded as confidential, whether it is business or personal information. We undertake not to, at any time, either directly or indirectly use or disclose any information you choose to share in any session. NLP Coaching: ART Your Life Coaches use NLP Techniques. NLP coaching and personal coaching is in no way to be construed as psychological counselling or any type of therapy. Results are not guaranteed. The client enters into the sessions with the full understanding that they are responsible for creating their own results. You Agree: Your coaching program is dependent on your level of commitment throughout the process. To abide by the mutually agreed time frames to complete all commitments. To ensure that they keep coaching appointments. You Understand: The information contained and presented in this program is useful for creating rapid and lasting change. I certify that my participation is of my own free will and I accept complete responsibility for my wellbeing at all times. I further certify that I am healthy and physically and psychologically fit to fully participate in this program and I know of no reason, nor have I been informed by my physician or psychologist (if relevant) of any reason why my participation would do me harm of any nature. I agree to release and hold harmless ART Your Life PTY LTD and Catie Kirke & Associates, their agents, representatives and employees for the results of any portion of the coaching program, in which I voluntarily participate. I understand that this coaching program may raise emotional issues for me but that it is not intended to provide a therapeutic environment or be a substitute for ongoing counselling or psychotherapy and that any unresolved issues which may surface and which may warrant counselling, will be at my expense. I acknowledge that I have carefully read, understood and do agree with this participant agreement and release form. Submit
