Name *

First Name

Last Name

Phone *

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I am seeking these services: *

Individual Coaching

Couples/Relationship Coaching

Open Relationship Coaching

Adult Family Coaching

Veteran Support

For Relationship Coaching, enter PARTNER'S NAME and INFO here. Additional members can be added at the bottom of form.

First Name

Last Name

Phone

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I prefer: *

In-Person - New Braunfels, TX

Virtual Only

Combination of In-Person & Virtual

Mostly, I'm looking for help with: *

Anger Management

Anxiety/Stress

Career Exploration/Transitions

Communication Issues

Conflict Resolution

Depression

Divorce/Separation/Break Up

Grief/Loss

Infidelity

Life Transitions

Low Self Esteem

Low Sex/No Sex

Military Life/Challenges

Opening Up Relationship

Parenting

Personal Growth

Relationship Issues

Sex "Addiction"

Sexuality/Exploration

Trauma/PTSD

I'm available during these days and times:

Mondays *

Morning

Afternoon

Not Available

Tuesdays *

Morning

Afternoon

Not Available

Wednesdays *

Morning

Afternoon

Not Available

Thursdays *

Morning

Afternoon

Not Available

Fridays *

Morning

Afternoon

Not Available

How did you hear about us?

Personal Referral

Referred by Counselor/Coach

Referred by Doctor

Internet Search

Psychology Today

Facebook

Instagram

TikTok

Linked In

Podcast

Blog

You Tube

Other

Please read and check BOTH boxes: *

I understand that coaching is a separate service from therapy. Coaching does not provide diagnosis or treatment of mental health conditions and should not be considered a substitute for counseling or psychotherapy.

I understand that coaching services are not covered by insurance and are offered on a self-pay basis only.

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First Name

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