Work with Katie

1
Unique ID
2
Name* This field is required.
First Name
Last Name
3
Email* This field is required.
example@example.com
4
What is your Instagram handle?* This field is required.
5
How did you hear about Katie?* This field is required.
Instagram
Facebook
LinkedIn
Internet Search
Podcast
Referral
Other
6
Why do you want to be coached and mentored by Katie?
Huge
Large
Normal
Small
Ok
Ok
7
Have you had experience being coached by Katie (whether that's privately, in a group, or in one of her digital courses?)* This field is required.
Yes
No
8
Do you own your own business, currently?* This field is required.
Yes
No
9
What are your business goals? Be as specific as possible* This field is required.
10
Tell me about your business - What do you do? Be as specific as possible* This field is required.
Huge
Large
Normal
Small
Ok
Ok
11
How much are you making on average each month (in USD?) Be as accurate as possible (this will help later, you'll see)* This field is required.
Huge
Large
Normal
Small
Ok
Ok
12
Are you in a season where your business income is increasing or decreasing? Again, no judgment just curious so I can support you.* This field is required.
Huge
Large
Normal
Small
Ok
Ok
13
What's working in your business and what's not working, right now? No judgment - just curious so I can mentor you the best way I can.* This field is required.
Huge
Large
Normal
Small
Ok
Ok
14
What are your personal life goals? Be as specific as possible* This field is required.
Huge
Large
Normal
Small
Ok
Ok
15
What's working in your personal life and what's not working, right now? No judgment - just curious so I can mentor you the best way I can.* This field is required.
Huge
Large
Normal
Small
Ok
Ok
16
How often are you in your head about your life and/or business?* This field is required.
ALL THE TIME - I’m losing sleep over it!
More than I’d like - I feel like I’m thinking too much and not doing enough
Average - I feel balanced in this department
Rarely - I will get in my head sometimes, but it doesn't impact me that much
Never - I don't get in my head at all
Other
17
How often do you experience any of these cognitive symptoms?* This field is required.
Frequently
Sometimes
Rarely
Overwhelmed
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Numb
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Procrastination
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Low motivation
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Brain fog
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Stuck
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Irritability
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Anxiousness
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Overwhelmed
Numb
Procrastination
Low motivation
Brain fog
Stuck
Irritability
Anxiousness
Frequently
Row 0, Column 0
Sometimes
Row 0, Column 1
Rarely
Row 0, Column 2
Frequently
Row 1, Column 0
Sometimes
Row 1, Column 1
Rarely
Row 1, Column 2
Frequently
Row 2, Column 0
Sometimes
Row 2, Column 1
Rarely
Row 2, Column 2
Frequently
Row 3, Column 0
Sometimes
Row 3, Column 1
Rarely
Row 3, Column 2
Frequently
Row 4, Column 0
Sometimes
Row 4, Column 1
Rarely
Row 4, Column 2
Frequently
Row 5, Column 0
Sometimes
Row 5, Column 1
Rarely
Row 5, Column 2
Frequently
Row 6, Column 0
Sometimes
Row 6, Column 1
Rarely
Row 6, Column 2
Frequently
Row 7, Column 0
Sometimes
Row 7, Column 1
Rarely
Row 7, Column 2
1 of 8
18
How often do you experience any of these physical symptoms?* This field is required.
Frequently
Sometimes
Rarely
Headaches
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Insomnia
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Fatigue
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Diarrhea or Constipation
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Acne
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
PMS, painful or heavy cycles, hot ashes
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Low sex drive or trouble reaching orgasm
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Nausea/Heartburn/Upset Stomach
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Pain
Row 8, Column 0
Row 8, Column 1
Row 8, Column 2
Headaches
Insomnia
Fatigue
Diarrhea or Constipation
Acne
PMS, painful or heavy cycles, hot ashes
Low sex drive or trouble reaching orgasm
Nausea/Heartburn/Upset Stomach
Pain
Frequently
Row 0, Column 0
Sometimes
Row 0, Column 1
Rarely
Row 0, Column 2
Frequently
Row 1, Column 0
Sometimes
Row 1, Column 1
Rarely
Row 1, Column 2
Frequently
Row 2, Column 0
Sometimes
Row 2, Column 1
Rarely
Row 2, Column 2
Frequently
Row 3, Column 0
Sometimes
Row 3, Column 1
Rarely
Row 3, Column 2
Frequently
Row 4, Column 0
Sometimes
Row 4, Column 1
Rarely
Row 4, Column 2
Frequently
Row 5, Column 0
Sometimes
Row 5, Column 1
Rarely
Row 5, Column 2
Frequently
Row 6, Column 0
Sometimes
Row 6, Column 1
Rarely
Row 6, Column 2
Frequently
Row 7, Column 0
Sometimes
Row 7, Column 1
Rarely
Row 7, Column 2
Frequently
Row 8, Column 0
Sometimes
Row 8, Column 1
Rarely
Row 8, Column 2
1 of 9
19
What did you like about your experience with business coaching/courses in the past? Did you feel like anything was missing?
20
Imagine it's 6 months from today, what are we celebrating that you have accomplished during our time coaching, together?* This field is required.
21
What else should Katie know about you to help her coach you to give you the best experience & be as supportive as possible?
Should be Empty: