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KW- Consult Form
Would you like a FREE 20- Minute Breakthrough Call to discuss coaching questions and set up a consultation from there?
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Yes, I have questions.
No, I am ready to book a consultation now.
Not, sure I am just filling out the form and unsure as to what I want.
Name
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Email
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Phone Number
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Date of Birth
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Your relationship label is.
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Single
Married/CoupledTraditional
Married/Coupled Untraditional
Divorced/Widowed
Please share what your primary desire to work with KW Coaching/Integration is.
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Have you ever had a private coach before for ANY part of your life?
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Yes.
No.
Which are you interested in?
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Individual Coaching (Accepting New Clients Worldwide)
Couples Coaching (Accepting New Clients Worldwide)
Integration (Join the 2023 Wait List for this Program)
How do you want to do coaching?
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Phone Coaching
Zoom
Google Duo
Are you willing to invest in your process fully if we decide to work together?
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Yes! Absoluetly. I fully understand the power of investing into myself and committing to the process.
I am unsure as to what I want or my commitment level.
No, I am just exploring options at this time.
You understand that if you choose to have a a consultation with Kw that this is a 60-minute session here we will discuss the background of your story and your goals for future. This is different than the Breaththrough Free Call and there is a fee for the consultation hour. Current Pricing for Consult is $75 ( SAVE $100 for a limited time NOW). You may submit this form for the Breakthrough FREE Call as well but must understand that you will be encouraged to do the consult afterward unless you want to move directly to coaching options with KW.
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Yes.
How do you want to do your consultation? Please choose only one.
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Phone Call
Google Duo
Zoom
Did someone refer you?
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Yes
No
Agreement on Medical/Therapy Terms, Terms of Service and Refunds
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I Agree to all above terms of use, privacy, coaching expectations and agreements as well as refund policies.
I agree by electronic agreement here ( checking box above) that I have read and understand all terms of service, refund policies and medical/therapy terms as well as what expectations of 1:1 coaching is. I agree that I have read all said listed items below and will adhere to them. ( All said items can be located on front of this website as well as at the pottom of all private coaching pages on this website.) *REFUND POLICY *WHAT IS UNLIMITED COACHING *PRIVACY & TERMS OF USE *The Website/Coaching Does Not Provide Medical/Therapy Advice The contents of the Website/Coaching is for informational purposes only. The content has not been evaluated by the FDA and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your qualified health provider with any questions you may have regarding a medical condition. You should seek medical attention before undertaking anything described on the Website/Coaching. I do not recommend self-management of one’s health care. Reliance on any information provided on this Website/Coaching is solely at your own risk. Information obtained by using the Website/Coaching is not exhaustive and does not cover all ailments or their treatment. The content provided on the Website/Coaching is compiled from numerous sources. I do not practice medicine/therapy or provide medical or theraputic services. Never disregard medical/therapy advice because of something you have read or learned on/from the Website/Coaching platforms or appointments. If you think you may have a medical emergency, call 911 immediately.
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