Private ClientIntake Form Name * First Name Last Name What kind of support are you looking for? * Personal/Spiritual Business/Creative All Of The Above What are the challenges you're currently facing that you are seeking support on through coaching? * What have you done in the last 3-6 months to overcome these challenges? * What's your goal/vision for the future? What would success & overcoming these challenges look & feel like? * 3 words that best describe yourself * When it comes to spirituality & religion, how do you identify? * Anything else you'd like JB to know? Thank you!