Book a Private Individual Communication Coaching Session

Private Individual Conscious Communication
Coaching Session Intake Form
For your privacy, your answers are held in strict confidentiality.

First and Last Name

Phone

How did your hear about Miles and Conscious Communication Skills and Coaching?

Have you read the Conscious Communication book or taken the Conscious Communication Online Course?

Are you now, or have you been to private coaching or counseling before? If so, how is that working / did that work?

What is your primary reason and motivation to have a private Conscious Communication Coaching Session? How would you describe the current quality of your significant relationships and experiences in communicating with each other?

Are you looking for an in-person or online session? What dates are you available? (In-person sessions are available in Panton , Vermont, depending upon Miles' travel schedule.)

Thank you for completing our intake form.

Private Individual Conscious Communication Coaching Session Intake Form For your privacy, your answers are held in strict confidentiality.

Private Individual Conscious Communication
Coaching Session Intake Form
For your privacy, your answers are held in strict confidentiality.