I'm so happy you are here! I can't wait to start this journey together and so look forward to helping you live your right life. This intake form provides a wonderful pushing off point for us, and starts a process of reflection for you. If you do not feel comfortable answering any of the questions, just skip them. This is not a test!

Phone Number *
Phone Number
This is the phone I will call for our sessions.
Mailing address *
Mailing address
How did you hear about Signe and Earth Axis Within?
Check all that apply
Please check to acknowledge your agreement with each policy *
You will also receive a copy of these policies in your welcome packet.
As a client Signe expects you to
As your coach, you can expect Signe to
Complete the following sentences. Whatever comes to mind first is perfect! Can't think of anything? Skip it.
Rate these statements about different aspects of your life.
Rate these statements about different aspects of your life.
I have an excellent quality of life.
I have little stress in my life.
I have a life's purpose.
I am contributing to a better world.
I often lose track of time because I'm doing something I love.
I spend time in comfortable solitude.
I have a deep sense of belonging to the Earth.