Welcome to Intuitive Coaching

Please fill out the following information at least 72-hours prior to your first session with Derneeka.

All information obtained is to create the client’s Birth Chart and determine the makeup of their Human Design. This information is used to help the coach and client have a deeper understanding of who the client is.

02:30 PM

Family Life Satisfaction Survey


Please rate your current levels of life satisfaction on a scale from 0-10 in the following areas. 0 represents completely dissatisfied and 10 represents completely satisfied.


What goal(s) will you set for yourself for the next 90 days?

Your Signature

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