I'm excited to talk with you and see if what I offer is a fit for what you're looking for.
To make the best use of our time during this call, please share with me as much information as you're comfortable.
What led you to seek executive functioning coaching?{"type":"textarea","name":"__generic","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
Have you worked with a coach, therapist, or mentor before?
{"type":"radio","name":"__generic","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please choose one of the above options.","options":"YES\nNO"}
If yes, what was helpful or unhelpful?
{"type":"textarea","name":"__generic","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
Do you have a formal diagnosis related to executive functioning?
e.g., ADHD, Autism, Anxiety, Dyslexia, etc.
(it's fine if you don't, or if you'd rather not disclose)
{"type":"radio","name":"__generic","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please make a selection for this item.","options":"Yes\nNo"}
What are your biggest executive functioning challenges? (Check all that apply)
{"type":"checkbox","name":"__generic","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please check at least one item.","options":"Time management & scheduling\nTask initiation & procrastination\nOrganization & planning\nEmotional regulation & stress management\nFocus & attention control\nDecision-making & problem-solving\nManaging transitions & flexibility\nOther (please elaborate)"}
{"type":"text","name":"__generic","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
What specific outcomes do you hope to achieve through coaching?
{"type":"textarea","name":"__generic","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
What do you think will be most challenging for you?
{"type":"textarea","name":"__generic","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
How do you feel about the prospect of being coached?
{"type":"radio","name":"__generic3","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please weigh in on how this process is landing for you.","options":"Terrified\nBad\nOkay, I guess\nPretty good\nGenuinely excited"}
How do you prefer to receive feedback and be held accountable?
{"type":"radio","name":"__generic","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please choose one of the above options.","options":"Gentle reminders\nStructured check-ins\nFirm deadlines\nNone of the above\nOther (please elaborate)"}
{"type":"text","name":"__generic","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
Are there any specific accommodations or considerations that would help make coaching more effective for you?
{"type":"textarea","name":"__generic","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
Do you have any questions or concerns about coaching?
{"type":"textarea","name":"__generic","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
