New client intake form Name Date of birth Current marital status Length of marriage/relationship Date of separation /Divorce final Address Phone Do you have children? If so how many and ages If you are in the middle of a divorce, can you tell me about your current custody arrangement (time division, legal and physical) Are you having a divorce or custody battle, if so, can you describe in a nutshell? Describe your goals for coaching? What do you hope to accomplish? If you were going through a divorce, what topics are you most interested in exploring? (Setting boundaries, communication, emotional support, documentation, protection) By check this box, I acknowledge that Justine Weber, LLC is not qualified to provide legal advice. Justine Weber, LLC is able to offer support during healing after narcissistic abuse, and /or during a difficult divorce or custody battle. You are also acknowledging that you have thoroughly read through the information policies, which was supplied to you, and you agree to all policies and information outlined. I look forward to working with you. Thanks for trusting me and walking this path with you. Send