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1
Name
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First Name
Last Name
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2
Which
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Don't worry, I'm not going to spam you. Please double check that your email is correct before proceeding.
example@example.com
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3
What country are you from?
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The country where you currently reside
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4
Please select the age range that you fit into.
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14-17
18-25
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35-49
50+
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5
Select any of the following that apply to you:
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Anxiety can affect us all differently. Thank you for being honest.
I overthink and worry about the future
I deal with social anxiety and have trouble making friends
I convince myself I can't do certain things
I experience intrusive thoughts that can be pretty scary at times
I feel like I'm just not good enough
I have trouble sticking to a routine and schedule
I'm just not happy with my life right now
I deal with depression as well as anxiety
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6
What excites you? What do you love to talk about and really love doing?
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7
Tell me about what you do to manage anxiety or depression. What hasn't helped at all? What has brought you some relief?
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8
Do you currently have income to work 1-1 with Scott?
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Scott has the capacity to work with a few people on a sliding scale depending on their income.
Yes, I have the financial resources
No, I do not have the financial resources
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9
How did you hear about me?
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YouTube
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Conquer Anxiety Program
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