Contact | Melissa Rapp Coaching

Tell me about your family to begin this journey of growth and transformation.

Complete this form and then schedule your free consultation with me.

First name

Last name

Phone

How do you prefer to be contacted?

Generally, what days of the week and times of day are you available?

Who is in your family? (feel free to include any furry family members here, too!)

Family Dynamics:

How would you describe the ease or difficulty of communication with your partner?

What's your family's experience with communication with your kids?

For your family, how much of a challenge are sibling relationships?

Children's Social and Academic Life

Do the kids in your home generally make and maintain friendships easily, or is it more of a challenge?

When it comes to social pressure, how would you describe your family's experience with it?

How much of a challenge is school for your family?

Regarding learning differences, how often does this present difficulty for your family?

Personal and Health Topics

How would you characterize your family's dynamic around gender identity?

Thinking about sexual curiosity, how often does this present tension for your family?

When it comes to physical health, how often is this a concern for your family?

How would you describe your family's experience with sleep patterns?

For your family, how much of a challenge are eating patterns?

Emotional and Behavioral Patterns

How would you describe your family's experience with mental health?

How would you characterize your family's experience with anxiety?

How often does depression create difficulties within your family?

Regarding mood changes, how often is this an issue for your family?

Habits and Interactions

How would you describe the role of secrecy in your family's dynamic?"

How would you characterize your family's experience with respect among members?

For your family, how much of a challenge is organization?

How would you describe your family's overall approach to time management?

Are executive function deficits a likely culprit of family conflicts?

When it comes to self-regulating, how often is this a trouble for your family?

How often does difficulty with self-regulation create problems in your family?

Please describe the challenges you experience.

What attempts to remedy these challenges have already been made? Share more about the journey that has led you here today.

How can I help? Share anything you would like me to know.

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