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17
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1
Your Name
First Name
Last Name
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2
Email (use the same email you booked the conversation with)
example@example.com
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3
What area(s) are you mostly interested in developing?
Social freedom/confidence
Social life
Dating life
Self-love
Heal negative emotions
Self-acceptance
Meditation and mindfulness
Spiritual awakening
Clarity of my purpose/calling in life
Reduce self-doubt
Reduce social anxiety
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4
What's your GOAL? What do you want your life to look like in 12 months?
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5
What's stopping you from achieving your goal?
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6
Do you have any experience with practices to calm the mind (meditation, yoga, mindfulness, breathing exercises etc)? If so, describe what practices and your experience with them...
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7
"In the past years, the books I learned the most from are..."
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8
Do you have experience with practices that process emotions? (Psychotherapy, other therapies, spiritual practices, etc). If so, describe your experience.
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9
My greatest challenges are?
I struggle loving/accepting myself
Not sure how to make friends
My self-doubt and self-criticism
My negative emotions
My self-sabotage
Not knowing how to build a social life
How to interact with people
How to interact with women
Courage to meet people
Courage to talk to women
I don't know what my purpose/calling is
I'm scared to take action towards my goals/purpose
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10
Tell me a bit about yourself: Country, age, living situation (do you live with by yourself, with your parents or roommates?), your type of profession or study.
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11
What have you done to reach your goal? What worked and what didn't?
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12
Right now...
I have the resources to invest in improving this part of my life.
I have access to the resources to invest in improving this part of my life.
I don't have time/money to invest in improving this part of my life.
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13
"If I was told to talk to a woman or stranger on the street, I would..."
This doesn't apply to my focus
"know that it's necessary to improve my social confidence."
"get a little scared, but with good support and if I was taught a well-documented approach, I would do it, because I'm serious about improving my confidence and social life."
"I would not do it, even with guidance and even if I was told to say something simple like "hello"
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14
If I was told to go to a social meetup event near me, I would...
This doesn't apply to my focus
know that it's necessary to improve my confidence and social skills.
get a little nervous, but if I could pick an interesting activity I would do it, because I'm serious about improving my confidence and social life.
avoid it because I'm not really ready to make that kind of effort.
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15
How many minutes per day would you feel comfortable meditating?
Meditation: To be with yourself, your thoughts and emotions in silence (or following a guided meditation tape or meditation music).
I don't see how that would help me
A few minutes
5-10 minutes
10-20 minutes
20-40 minutes
More than 40 minutes
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16
"If I was told to invest 1000 dollars to go on a 2-3 week trip by myself to learn to be socially and spiritually independent, I would"...
go for it because I'm committed to doing whatever it takes to improve my confidence, self-independence and social skills.
get a little stressed, but if I could pick an inspiring place myself, I would do it, since I want to do the little extra to grow my confidence and social freedom.
Postpone it because I don't really have the time and would rather do things the cheaper way...
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17
On a scale from 1 to Will Smith, how cool are you?
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