COACHING INTAKE FORM

RESTORED LIFE ACADEMY COACHING INTAKE FORM

Welcome! You are on this page because you are ready to gain focus and clarity, grow and lead your life with intention. I am so excited that you've found us. Let's get started with you completing the form below so we can get to know you and be better able to serve you.
Full name*
Age at last birthday*
Email*
example@example.com
Telephone number*
Format: (000) 000-0000.
Social media handle*
Example: @t_bone-steak
What is your current profession? *
What pattern keeps repeating in your life despite your best efforts?*
(e.g., increased income, impact and influence)
What is now the moment you are willing to invest in real change?*
What have you tried already, and why didn’t it last?*
(e.g., learn how to tell my story, start my business, define my purpose)
On a scale of 1–10, how committed are you to doing uncomfortable work?*
If accepted, are you prepared to financially and emotionally invest in this process?*
Is there any question in particular that you would like answered?
Were you referred by someone? If so, Provide their full name and email*
Please verify that you are human*
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RESTORED LIFE ACADEMY COACHING INTAKE FORM