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Saema Wellness Coach
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About Me
Consultation
Numerology
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Menu
Home
About Me
Consultation
Numerology
Contact
Book A Call
Please fill below details
1. Personal Information
Full Name:
*
Preferred Name/Nickname:
*
Email Address:
*
Phone Number:
*
DOB
Occupation / Current Work:
Relationship Status:
2. Emergency Contact
Name:
*
Phone Number:
*
Relationship:
3. About You
How did you hear about me?
What made you decide to book this session today?
What areas would you like support with?
Confidence & Self-Worth
Anxiety / Overthinking
Emotional Healing
Relationships / Marriage
Stress Management
Motherhood / Postpartum Support
Purpose & Motivation
Self-Love & Personal Growth
Life Direction
Career / Work
Mindset Reset
Spiritual Growth
4. Goals & Challenges
What currently feels most challenging in your life?
What would you like support with during coaching?
If our coaching sessions were successful, what would life feel like in 3–6 months?
What is one goal you want to achieve?
5. Wellness & Lifestyle
How would you rate your stress level right now? (1–10):
How would you describe your emotional wellbeing?
Struggling
Neutral
Doing Okay
Thriving
Do you currently feel supported by people around you?
Yes
Somewhat
No
Are you currently working with a therapist or counselor?
Yes
No
Prefer not to say
6. Motherhood / Postpartum (Optional)
Pregnant
0–12 Months Postpartum
1+ Year Postpartum
Not Applicable
What has motherhood/postpartum felt like emotionally for you?
7. Session Preferences
What do you hope to gain from coaching with Saema Hashme?
How would you like to feel after our sessions?
Calm
Confident
Motivated
Emotionally Stronger
Supported
Empowered
Preferred Coaching Style:
Gentle & Supportive
Direct & Motivating
Balanced
8. Agreement
I understand life coaching is not therapy, diagnosis, or medical treatment.
I understand results depend on my participation and consistency.
I agree to show up honestly and respectfully for my sessions.
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