Jeffrey M. Keefer, Ph.D.
Educational Consultant & Coach

Contact Jeffrey

Digital Habit Coaching Intake Form

Hi! My name’s Jeffrey, and I’m honored to be your coach!

To get started, I want to learn a few things about you that will help me support your getting on the path to success as quickly as possible. This brief form below should take about 5-10 minutes to complete, and your responses will not be shared with anybody.

Please answer with as much detail as you are comfortable sharing, as the more I know about where you are in relation to your goals, the more specific I will be able to provide coaching to you. I will cc you with a copy of your responses for your records.

I am usually in New York City, so I am in EST which is GMT -5.

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