Thank you! Please fill out below a short survey we need prior to your consultation

"Family Relationship Coaching"
with Luis Angel Diaz

.

Before we set up our initial consultation together, please fill in this short questionnaire.

Initial consultations are free of charge, and are 30 minutes in length. Please note: a consultation is NOT a coaching/therapy session. The purpose of the consultation is to get to know each other and assess which, if any, of our CMR offerings are best suited to your needs.

I look forward to speaking with you soon!
Luis Angel Diaz

First Name:

Last Name:

Main Telephone:

Email:

Country:

1. What is your gender?

2. What is your age group?

3. Which relationship would be the primary focus of our work together?

4. Please tick all that apply to your current family situation:

  a. I am currently in a committed relationship that is LESS than 3 years old
 b. I am currently in a committed relationship that is MORE than 3 years old
 c. I am currently living with BOTH a partner/spouse and child/children
 d. I am currently a SINGLE PARENT
 e. I am currently NOT living with either a partner or children
Other:

5. What would you most to like to gain from our working together?

6. What qualities would a coach/facilitator need to have to make you feel safe and supported?

7. What else would like me to know (if anything) before we schedule our free consultation?