Intake Form | Shadow Walker Coachi

Shadow Walker Coaching & Tarot Client Intake Form

Trauma-Informed Spiritual Life Coaching with a Witchy Twist

Client Information

First name

Last name

Preferred Name (if different)

Pronouns

Birthday

Month

Day

Year

Email

Phone

Preferred Method of Contact

Email

Text

Phone

Emergency Contact

How did you hear about Shadow Walker Coaching?

Identity & Accessibility

(These questions help me ensure sessions are safe and inclusive. You may skip any that feel uncomfortable.)

Do you identify as part of the LGBTQIA+ community?

Do you identify as neurodivergent or disabled?

Are there any accessibility needs I should be aware of (visual, auditory, mobility, processing, etc.)?

Do you have any trauma triggers or topics you’d like me to be aware of during our work together?

Coaching Goals

What inspired you to seek spiritual life coaching at this time?

What areas of your life feel most “out of alignment” or in need of support? (Check all that apply)

If you could shift or heal one pattern right now, what would it be?

How do you currently define “healing” for yourself?

Spiritual Practice & Beliefs

(No wrong answers here — this helps me understand your background and comfort zone.)

Do you identify with a particular spiritual or religious path?

What does “spirituality” mean to you?

Are there practices you currently use for grounding or reflection (tarot, journaling, prayer, meditation, ritual, etc.)?

Are there any spiritual beliefs, communities, or experiences that have caused harm or left you feeling “othered”?

Emotional & Nervous System Awareness

How would you describe your current stress level?

Low

Moderate

High

How does your body usually tell you when you’re overwhelmed or disconnected?

What helps you calm or regulate when you’re feeling activated?

Have you worked with a therapist, counselor, or energy practitioner before? If so, what was helpful (or not)?

Support & Structure

Which service(s) are you interested in?

1:1 Coaching

Shadow Work Integration

Tarot Insight Session

Ritual / Energy Work Guidance

Preferred Session Length

30 Minutes

60 Minutes

Frequency

Weekly

Biweekly

Monthly

Time zone & general availability

Agreements & Boundaries

Coaching is not therapy or medical treatment. Do you understand and agree?

Yes

No

Everything shared in session is confidential unless safety is at risk. Do you agree to uphold mutual respect and honesty within sessions?

Yes

No

Is there anything else you’d like me to know before we begin?

Signature

By signing below, you acknowledge that you are entering into a collaborative coaching relationship focused on self-awareness, healing, and growth.

Signature

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Date

Month

Day

Year