Free Ph.D. Executive Coaching Consultation

Dr. Marshall Colt, our head coach provides a free, phone (or e-mail) consultation to assess and discuss your executive situation with you.  You and Dr. Colt together will get clear on exactly what it is you want, then discuss strategies and an action plan to get you there.  He will then tell you if and how he may be of service, and the costs. 

There's no risk or obligation.  And remember, coaching fees are U.S. tax-deductible as a qualified, work-related education expense to maintain or improve skills (Schedule A, line 20 and/or Form 2106, line 4).

Please submit the information below for our head coach, Dr. Colt, to review.  All information is kept strictly confidential and is encrypted using PGP technology.  Privacy notice

Full Name

Company/Organization  How long?

Position   Stress level

Address

City  State/Province

ZIP/Postal code  CountryUSA AfghanistanAlbaniaAlgeriaAndorraAngolaAnguillaAntigua And BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanAzoresBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia HercegovinaBotswanaBrazilBrit.virgin Is.BruneiBulgariaBurkina FasoBurundiCameroonCanadaCanary IslandsCape VerdeCaroline IslandsCayman IslandsCentral African RepChadChileChinaChina Peoples RepColombiaComoros IslandCook IslandsCosta RicaCote D'ivoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IsFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgetownGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuineaGuinea BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKampuchea (cambodia)KazakhstanKenyaKoreaKuwaitKyrgystanLaos Dem Rep OfLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMadeira IslandsMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMexicoMiquelonMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmar (burma)NamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNorwayOman SultanateOtherPakistanPalauPanamaPapua New GuineaParaguayPeo. Rep. Of CongoPeruPhilippinesPitcairn IslandsPolandPortugalQatarRep Of KoreaRep. Of HungaryRep. Of KiribatiReunion Is.RomaniaRussiaRwandaSao Tome IslandSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSt HelenaSt KittsSt LuciaSt. VincentSudanSurinameSwazilandSwedenSwitzerlandSyriaTadikstanTaiwanTanzania Union Rep OfThailandTogoTongaTrinidadTristan Da CunhaTunisiaTurkeyTurkmenistanTurks & Caicos IslTuvalu IslandUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican City StateVenezuelaVietnamWestern SamoaYemenZaireZambiaZimbabwe

E-mail(Must be proper e-mail format: xxx@yyy.zzz)

Telephone  
(Include area code, please; or country and city codes, if appropriate)

FAX  URL(http://www.xxxxxx.yyy)

Please describe your executive coaching needs and specific goals to the extent you feel comfortable (kept confidential):

I prefer to be coached via (please check one):
  Telephone   In Person   Instant Messaging (IM)*  E-mail*
* available only to international clients, please.

How you heard about Dr. Colt or Advance Coaching: Please choose one: Employer referral Friend / Colleague Magazine: (please name on line below) Medical Group Management Association (MGMA) National Association of Working Women Newspaper: (please name on line below)   "The Chicago Tribune"   "The San Diego Ph.D. Business Journal"   "The San Diego Post"   "The San Diego Rocky Mountain News"   "The International Herald-Tribune"   "USA Today"   "The Wall Street Journal"   "The Washington Post" Radio:   KFYI-Phoenix   WGN-Chicago   WOR-New York Search Engine:  (please name it and your search term on line below)   About.com  (please type in your search term on line below)   AOL  (please type in your search term on line below)   Google  (please type in your search term on line below)   Lycos  (please type in your search term on line below)   MSN  (please type in your search term on line below)   Yahoo  (please type in your search term on line below) Television:   KABC-TV  Los Angeles   ABC's "Good Morning, America" Yellow Pages

More specifically, please:
(who, which, what, when, where, how, etc.)

ALL fields, except URL, require an entry, please.  Also, your e-mail address must be in the proper format (xxx@xxx.xxx) or you'll have to re-post your information. Please double-check your information before clicking Submit.