Client Intake Form

Welcome to My Autism Gifts where I celebrate and empower the remarkable diversity of Autism. With my personalized coaching and unwavering belief in the power of every person, I invite you to fill out the below for.

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Personal Information.

Name

Phone Number

Address

Address Line 1

City

State / Province / Region

Country

Preferred Pronouns

Date of Birth

Occupation/Profession

How did you hear about us?

Background Information

Briefly describe your background and current situation (work, family, interests, challenges, etc.).

What motivated you to seek our services?

Have you worked with a coach or consultant before? If yes, please share your experience.

Goals and Expectations:

What specific goals or outcomes do you hope to achieve through our services?

What challenges or obstacles are you currently facing in your personal or professional life?

What do you expect from our coaching/consulting relationship?

Areas of Focus

Please select the areas you're interested in working on (e.g., career development, personal growth, relationship improvement, etc.).

Other (please specify)

Previous Experience and Skills:

Do you have any previous experience or training related to the areas you want to focus on?

What skills or strengths do you bring to the table that may help in achieving your goals?

Preferred Communication and Availability:

How would you prefer to communicate during our sessions (e.g., in-person, phone calls, video calls)?

What days and times are generally most convenient for you to schedule sessions?

Additional Information:

Is there any other information you think would be helpful for us to know before our discovery meeting?

Do you have any specific questions or concerns you'd like to address during our initial consultation?

By submitting this intake form, you agree that the information provided is accurate and that you are willing to participate in our discovery meeting and potential coaching/consulting sessions.