Please take a few minutes to fill out this survey and provide some insights into your current position, experience negotiating, and your goals for working together.  

The more information you share on this form, the more efficiently we can use our time together.

Any time you can provide an example or context for your experience, please share it!  Don't feel like your answers have to be perfectly crafted or grammatically correct. This isn't graded.

I look so forward to talking with you soon.

- Lelia

Shared Agreements

To ensure you get the most out of our time together, it’s important that we have a shared understanding of what we can expect from one another. Please review the agreements below.

  • I agree to open and honest communication, to being fully present during time together, and to being open to feedback and assistance. 
  • I understand that written and verbal communication (including this survey) are confidential and will be protected as such.
  • If I am late for an appointment, my session will be shortened.
  • I will re-schedule any appointments 24 hours in advance, or forfeit the appointment and pay the fee.
  • After two missed appointments without re-scheduling, the relationship may be terminated without refund.
  • I understand that all one-on-one packages expire after 3 months from payment date unless another timeline is otherwise agreed upon.
  • I understand that this support is not a substitute for professional advice by legal, mental, medical or other qualified professionals and will seek independent professional guidance for such matters.
  • I hereby release, waive, acquit and forever discharge, Gowland, LLC from every claim, suit action, demand or right to compensation for damages I may claim to have or that I may have arising out of actions, omissions, or commissions taken by myself or by Gowland, LLC as a result of the advice given by Gowland, LLC or otherwise resulting from the coaching relationship contemplated hereunder. I further declare and represent that no promise, inducement or agreement not herein expressed has been made to me to enter into this release. The release made pursuant to this paragraph shall bind my heirs, executors, personal representatives, successors, assigns, and agents.


Name *
Demographic Information
I work with women at various stages of their careers, so I ask the questions below to provide context about where you are professionally. If you prefer not to share, please leave any part of this section blank.
Type your name here.