Terms & Conditions: I understand that the information submitted on this form will not be treated as confidential. Therefore, I will not provide any confidential information on this form. Furthermore, I understand that any information submitted on this form shall not be used by Eyes Wide Open for any other purpose than to schedule a complimentary consultation. Completion of this form does not satisfy the requirements of a legal contract for coaching services, and therefore does not constitute a coach-client relationship with Eyes Wide Open, its founder and/or its staff.