Please download the form you need, type in your answers and email the completed copy to or submit the completed copy to her at your first appointment.

New Client Form

If you decide that you would like to book an appointment, please complete the new client form. The information requested is necessary to better understand your coaching/counselling goals. Please be assured that all information submitted will be kept confidential. Your health information is private.

Consent Form

I feel it is important that you understand the services I hope to provide, so you may be informed upon your consent to coaching/counselling with me. By reviewing and agreeing to the information presented in this form, you will be informed of the process of coaching/counselling and how I handle personal information.

Email & Text Messaging Communication

During your course of coaching/counselling, if you wish to contact Kimberly Bentley via email or text message, please complete this form stating which method works best for you.

Financial Agreement & Disclosure

In compliance with ethics and standards, it is required to disclose all billing and financial matters regarding your coaching/counselling. The following agreement and disclosure outlines payment for your coaching/counselling services.

Skype Coaching/Counselling Sessions

Skype appointments can be available to clients as a convenience if it is determined they are appropriate. Clients must agree to the following guidelines for Skype or other video/visual conferencing services.

Girls’ Time Registration Form – Fall 2018

Save the form, fill it it out and email it to