Completing Your Confidential Intake Form

Thank you for taking the time to fill out this important form. Please choose the method below that works best for you to complete and return it. We estimate this form takes approximately 45-75 minutes to complete thoughtfully.

Option 1: Complete Digitally & Upload Securely (Recommended)

This is the preferred and most secure method. You will fill out the form in your web browser, save it as a PDF with your answers, and upload it to our secure folder.

1. Fill Out the Form: Complete the form directly in your web browser.
   • Important: The form does not save automatically online. If you close your browser before saving the PDF in the next step, your work will be lost. If you need to take a break, it's best to save your progress as a PDF (following the steps below) and resume later by re-entering your saved information into a fresh copy of the form.
2. Save Your Completed Form as a PDF: Once you have finished filling everything out:
   • Press Ctrl+P (on Windows/Linux) or Cmd+P (on Mac) to open the Print menu.
   • In the Print dialog box, find the "Destination" or "Printer" setting.
   • Change the destination to "Save as PDF".
   • Click "Save".
3. Name the File: When prompted to name the saved PDF file, please use the following format: YourLastName_YourFirstName_Intake.pdf (e.g., Doe_John_Intake.pdf). Save it to a location you can easily find on your computer.
4. Upload Securely: Click the link below (also found at the bottom of the form) to access our secure upload folder, and upload the PDF file you just saved:
   • Upload Completed Form Here

Option 2: Print, Complete by Hand & Mail

If you prefer, you can print the form and complete it manually.

1. Print the Blank Form: Open the form link in your web browser. Use the browser's Print function (File > Print or Ctrl+P / Cmd+P) to print the blank form pages.
2. Complete by Hand: Fill out the printed form clearly using a pen.
3. Mail the Form: Mail the completed physical pages to the following address:
   Rob Jackson
   Icebergology™ Coaching Academy
   PO Box 940324
   Maitland, FL 32794

Please reach out if you encounter any difficulties. We appreciate you taking the time to provide this information to help us prepare for our work together.