After enrollment is confirmed

Group Coaching Participant Intake

This short form helps Mendy prepare for your 8-week group coaching experience. Please complete it after your place in the program has been confirmed.

Help us prepare for a safe, supportive experience

Please answer a few simple questions. If you are taking medication or have a concern about participating, you can contact Mendy directly.

You do not need to share detailed medical information.
Please do not include medication names or doses.
If you are taking medication or have questions about participation, please contact Mendy directly.

Important: This is a non-medical coaching program. It does not provide medical care, psychotherapy, or mental health treatment. For medical or mental health concerns, please consult a qualified healthcare professional.

For confirmed participants. Please complete this short form so Mendy can prepare for your group coaching experience. If you have questions about participation, Mendy can follow up with you directly.

Full name*

Email address*

Phone number (optional)

Are you currently taking any medication?*

If you answered yes or are unsure, please contact Mendy directly before participating. You do not need to list medication names or doses in this form.

Is there anything else Mendy should know to help you participate comfortably? (optional)

I understand this is a non-medical coaching program. It does not provide medical care, psychotherapy, diagnosis, or mental health treatment. I will continue to seek advice from qualified healthcare professionals for medical or mental health concerns, and I will not stop or change prescribed medication or treatment based on this program.

I understand my responses will be sent to Klein's Coaching for review. I will share only information relevant to my participation. This form is not for urgent concerns.