Please fill out our Intake and Disclaimer forms.  Either print the hard copy forms below, fill out and mail in, or fill in our online forms below.

Coaching Intake form

Coaching disclaimer form


Coaching Intake Form

  • 1. Contact Data & General

  • 2. Health Information


Coaching Disclaimer Form

  • I understand that Carol Michalski, MSW, LCSW will provide me with in person, phone or Skype coaching and/or mentoring sessions. A session may last 1 hour.
    • Session cancellations and/or rescheduling must be made within a minimum of 24 hours before any scheduled session by phoning 414-331-9905.
    • It is the role of your coach to act as a guide during the coaching process. The results that you obtain from each session will depend entirely on the responsibility you take for taking action and making the changes you are after.
    • Coaching sessions are non-judgemental.
    Coach Disclaimer of Liability:
    Coaching is not therapy or a medical treatment. I am not diagnosing or treating any medical or psychological condition. I have not promised, shall not be obligated to, and will not act as a therapist providing psychological counseling.
  • MM slash DD slash YYYY

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