Coaching Forms

New clients: please print and fill out the forms from either Packet A or Packet B, and bring them to your first appointment with you. Thank you!

Packet A:
1. New Client Info Form
2. New Client Interview Form
3. Coaching Agreement
4. Coaching Session Prep Form

Packet B:
1. New Client Info Form with Brief Questions
2. Coaching Agreement
3. Coaching Session Prep Form

If you prefer, you may download all of the forms at once from one of these zipped files:
Packet A Forms
Packet B Forms


Additional Forms for Coaching Clients (to be printed as needed):
1. Client Interview Form
2. Coaching Session Prep Form
3. Completion Log
4. Mining for Values
5. Wheel of Life



805-623-4177  |  Santa Barbara, CA   

Jill Rubin, LICSW, Psychotherapist, Life & Relationship Coach

Jill Rubin, LCSW
Relationship Coach
Psychotherapist

Helping you live the life you desire, through relationship coaching and psychotherapy.

Book a free consultation
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Testimonials
"My first coaching session with Jill was surprisingly intense and powerful.  I came away from it with a bird's-eye view of my life, and a very clear sense of direction."
— K.M.

"I felt like I've been running in circles until now."
— M.B.