Book your complimentary Initial 30-minute Consultation with Coach Samantha now. Consultations are 30 minutes and take place via phone or video chat.

Duration: 30 minutes
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Thank you for booking an Initial Consultation with me. I look forward to connecting with you!

How did you hear about my coaching services? Please choose from the dropdown menu options.

Please choose from the following optionsPsychology TodayGoogle/web searchInternational Coach Federation (ICF)InstagramFacebookReferral, please specifyOther, please specify{"type":"select","name":"SourceOfClientInquiry","width":100,"value":"","size":"Normal","validation":"N1","validationMessage":"Please make a selection for this item.","options":"Please choose from the following options\nPsychology Today\nGoogle/web search\nInternational Coach Federation (ICF)\nInstagram\nFacebook\nReferral, please specify\nOther, please specify\n"}



If you chose "referral" or "other," please specify here:

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What is your age?

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What are your pronouns? Please type it in here. (For example: she/her, he/him, they/them)

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Where do you live? (For example: in which city/state/country)

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What is your job/employment status? (If you are unemployed, job seeking, and/or a stay-at-home parent, please include that info here.)

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Do you have ADHD? Please choose from the dropdown menu options.

Please choose one of the following:Yes, I have received a formal ADHD diagnosis.Yes, I have ADHD, but do not have a formal diagnosis.No, I do not have ADHD.I don't know if I have ADHD or not.{"type":"select","name":"ADHDStatus","width":100,"value":"","size":"Normal","validation":"N1","validationMessage":"Please make a selection for this item.","options":"Please choose one of the following:\nYes, I have received a formal ADHD diagnosis.\nYes, I have ADHD, but do not have a formal diagnosis.\nNo, I do not have ADHD.\nI don't know if I have ADHD or not."}



Have you worked with a coach (of ANY kind) before? Please type in your answer "yes" or "no" - if yes, please include what type of coach(es) you've worked with, either previously or currently.
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Please share 3-5 things you would like to potentially work on together in coaching.

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Is there anything else you would like to share before our call?
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{"type":"checkbox","name":"__generic","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please check at least one item.","options":"I confirm that I understand and agree to the following: I am commited to showing up for my complimentary Initial Consultation with Coach Samantha. In the event that I need to change or cancel this appointment, I will give at least 24 hours of written notice in advance of our scheduled call. I understand that, while I may be able to reschedule our appointment with less than 24 hours of notice, Coach Samantha may require that I pay a consultation fee upon rescheduling."}



{"type":"checkbox","name":"__generic","width":100,"value":"","size":"Small","validation":"CA","validationMessage":"Please check at least one item.","options":"Yes, I confirm I have reviewed your website, unconventionalmindscoaching.com, including the coaching fees page. I confirm that the coaching fees listed on the website are affordable to me (UNLESS I am taking part in a consultation to join the waitlist for a coaching scholarship). "}