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Ray helped me turn my life around — and he did it with great sensitivity and humor!

Raymond F. Angelini, Ph.D. — Business & Personal Coach

Read the testimonials of clients whom I helped to achieve their goals.


Schedule a Session Today!

Let's Start by Having You Tell Me About Yourself

In order to give our first session the best chance for success, I'll need a little information from you. Please fill out and submit the following form, including at least two times that would work for Monday-Friday between the hours of 9:00 A.M. and 6:00 P.M. (EST). Once I receive your sample session request, I'll get right back to you to confirm a time that works for both of us. Please be assured that any personal information you send with this client profile form will remain completely confidential. I look forward to hearing from you.

(Fields with an asterisk [ * ] are required.)

CLIENT PROFILE FORM


*Full Name:
*Home Address:
*City:
*State/Zip:  

Company:
Job Title:
Company Address:
City:
State/Zip:  

*Day Phone:
Evening Phone:
Fax:
*Email Address:

Date of Birth:
Referred by:

*Preferred session date/time:
*1st alternate date/time:
2nd alternate date/time:

  Please describe your:  
*Business/Personal Goals:
What results would you
like to obtain from coaching?
*Current Challenges:
What issues are you facing
now that are a roadblock to
achieving your goals?
What else . . .
do you want your coach
to know — e.g., concerns?
Past problems?
Special requests?

 
   

 


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Raymond F. Angelini, Ph.D. — New Horizons Coaching, P.C.

Business & Personal Coach and Licensed Clinical Psychologist

648 Maple Avenue
Saratoga Springs, NY 12866
phone 518.583.2679 ][ fax 518.583.1913
rayangel1@live.com