// 6 Session Coaching Programme

Client Intake Form

// Section 1

About you

Full name *

Email address *

Age

Location

Occupation / what you do for work right now

How did you find me?

// Section 2

Where you are

In a few sentences, describe where you are in your life right now. Not the polished version — the honest one.

What are you most tired of experiencing?

Where do you most notice this showing up? (tick all that apply)

// Section 3

Your journey so far

What work have you already done on yourself? (therapy, coaching, retreats, plant medicine, modalities etc)

What has shifted as a result of that work?

What hasn't shifted — despite everything you've tried?

// Section 4

What you want

If our six sessions together worked beyond your expectations, what would be different in your life?

What would you be doing, feeling, or experiencing that you're not right now?

What would you have stopped doing?

// Section 5

The pattern

What pattern do you keep seeing in yourself that you haven't been able to shift?

Where does it show up most right now?

In your own words — what do you think is underneath it?

// Section 6

Practicalities

What days and times work best for sessions? (we'll confirm scheduling separately)

Is there anything about the way you work best that I should know before we begin?

Is there anything going on in your life right now that I should be aware of before we start?

// Section 7

Agreement

By submitting this form you confirm that:

You have read and agreed to the This Is Asha Ltd Coaching Terms & ConditionsYou understand that coaching is not a substitute for medical or psychological treatmentYou are not currently in crisis or under active clinical care for a serious mental health conditionYou are committed to showing up fully for six sessions and doing the work between themYou understand that transformation requires your participation, not just your presence

This information is held in confidence by This Is Asha Ltd in accordance with UK GDPR and our privacy policy. It will never be shared with third parties and will be used solely to support the delivery of your coaching programme.