Book your Initial 30-minute Consultation with Coach Samantha now. (Please note: this consultation is complimentary, however, payment of a nominal, refundable $20 deposit reserves your appointment time.)

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.

Psychology 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":"\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.

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":"\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: The Initial Consultation is complimentary, however payment of a nominal $20 reservation fee is required to reserve my appointment time. If we decide to work together, Coach Samantha will apply this fee toward my initial payment for coaching services. If we decide to not work together, Coach Samantha will refund this fee to me ASAP once the Consultation is complete. In the event that I no-show for this appointment, my $20 payment is considered forfeit, and another payment will be required to rebook a Consultation with Coach Samantha for another time."}



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