NeuroClient Form

Welcome! Please share some information to help us tailor our Neurocoaching sessions to your needs.

First Name

Last Name

Email Address

Phone Number

Birthday

Month

Day

Year

Have you received an ADHD diagnosis?

YES

NO

EXPLORING

Choose only one.

Briefly describe your background and any previous support you've had.

This helps us understand your journey so far.

What are your primary goals for coaching?

Think about what you would like to achieve in the next 3-6 months.

What do you consider your greatest strengths?

ADHD often comes with unique talents—tell us what you're great at!

How do you like accountability?

Text check-ins

Email check-ins

Phone message check-ins

Choose only one

If coaching goes really well, what would change in your life?

What has helped?

What has not helped?

What energizes you?

What do others appreciate about you?

What should I know to best support you?

NeurAmazing Coaching

Thank you for inviting me into your story. Together, we will explore awareness, uncover strengths, create meaningful supports, and help you move forward in a way that works with your brain—not against it.

Contact NeurAmazing Coaching

NeurAmazing Coaching

NEUROMENU

Personalized ADHD coaching that celebrates your unique strengths, helping you navigate challenges, and empowering you to thrive with confidence and authenticity 🧠

NeuroClient Form