Welcome To Our Pole Journey

EXPLORE AND EXPAND YOUR MIND

Thank you for signing up for our Coaching Sessions. This will give me foundational knowledge about your goals for our time together. If you have any questions at all - please reach out to me right here. Also! Make sure to read through my terms and conditions before beginning. I’m looking forward to beginning our work together.

Name

First Name

Last Name

Email

What is your preferred mode of communication? Email, social media, etc.

How long have you been Poling?

What do/did you love about Pole? List as many things as you can.

What are your top 3 frustrations about yourself in regards to your pole practice?

Do you have a critical voice that speaks or yells at you?

What are your fears?

Do you have any limiting beliefs about yourself?

What are three things that lift your mood and spirit?

Have you ever had support from a coach, therapist, hypnotherapist, sport psychologist or other support modalities?

What would you like our work to be focused on? Overall.

What would you like the focus to be for this week?

Are you open to change? Are you willing to change? Are you ready to change?

How do you feel most supported?

What kind of accountability do you need?

EXPLORE AND EXPAND YOUR MIND

I WANT TO CAPTURE YOUR HEART AND INSPIRE YOUR MIND THROUGH POLE!