Discovery Session

Step 1 of 10 - Personal Information

10%

Full Name:(Required)

Enter your full name

Preferred Name (optional):

Enter your Nickname

Phone:

Enter your phone number

Email:(Required)

Enter your Email address

Country:(Required)

choose your country

State:(Required)

Enter your State / province

Preferred Language(Required)

English

Farsi

Best Way to Contact You:(Required)

Phone

What's App

I am requesting:(Required)

Free 20–30 Minute Discovery Session

Paid 60-Minute Initial Coaching Assessment Session

Preferred Format:

Video Call

Audio Call

In-Person (if available)

Your preferred time for the session (choose all that apply):

Days:

Saturday

Sunday

Thusday

Friday

Times:

Morning

Afternoon

Evening

(This section helps me understand your needs and prepare for the session.)

What brings you to coaching at this moment?

What are the top 3 challenges you are currently facing?

You can add your challenges by clicking on +

What are the top 3 goals you want to achieve in the next 6–12 months?

You can add your challenges by clicking on +

Have you worked with a coach, therapist, or mentor before?

Yes

If yes, what was helpful? What worked and what didn’t?

Rate each area from 1 (needs major improvement) to 10 (excellent):

Mental & Emotional Well-Being:

Confidence & Self-Worth:

Career & Professional Direction:

Relationships & Communication:

Personal Growth & Mindset:

Productivity & Habits:

Health & Lifestyle:

Purpose & Life Vision:

What do you hope to gain from this session?

(Clarity, guidance, roadmap, emotional support, etc.)

How ready are you for change?

Very Ready

Somewhat Ready

Unsure / Exploring

Please confirm the following:(Required)

I understand this session does not replace medical, psychological, or psychiatric treatment.

I understand this session is not emergency support.

I confirm that all information provided is accurate to the best of my knowledge.

I agree to the privacy, confidentiality, and professional boundaries described in the Coaching Agreement & Ethics Policy.

If you selected a paid session, choose your payment method:(Required)

Credit/Debit Card

PayPal

Bank Transfer

Other

Is there anything else you would like me to know before we meet?

consent(Required)

I confirm that I am submitting this form voluntarily and wish to proceed with the session.(Required)

Signature

Full Name

Coach Mahdi

Coach Mahdi

Life Coaching Discovery Session Request Form