1:1 Coaching Application

1
What is your name?* This field is required.
First Name
Last Name
2
What is your Email* This field is required.
example@example.com
3
What's the vision for your business? What are you here to create and why?
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Ok
Ok
4
What is your practice website?
5
Services - What services do you currently offer in your practice?* This field is required.
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Ok
6
Marketing - What's your current process for generating leads in your business?* This field is required.
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Ok
Ok
7
Team - Can you please describe the current team you have in place (if any)* This field is required.
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Ok
8
Finance - What is your average monthly practice revenue generated over the past 90 days?* This field is required.
Please Select
Please Select
$0
<$5,000 Per Month
$5,000-$10,000 Per Month
$10,000-$25,000 Per Month
$25,000-$50,000 Per Month
$50,000-$75,000 Per Month
$75,000-$100,000 Per Month
$100,000-$150,000 Per Month
$150,000-$300,000 Per Month
$300k-$500k
$500k-$1mm
$1mm+
9
Finance - What is Your Business Revenue Goal for the next 12 Months?* This field is required.
10
What's blocking you at the moment from achieving that revenue goal?
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Ok
11
Are there any other challenges in your practice right now?* This field is required.
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Ok
12
On a scale from 1-10, how urgent is it for you to achieve your 12 month revenue goal and address the challenges you're facing?
13
Are you ready and able to invest the financial resources to achieve your revenue goal while working less as the owner?* This field is required.Select the response that most accurately describes your willingness and ability to invest in coaching.
Please Select
Please Select
I have the necessary financial resources to grow my business
I can get the necessary financial resources to grow my business
I don't have the financial resources to grow my business and I'm happy with my current results
14
If your application is approved, can you commit to showing up to your private consultation on time?* This field is required.
YESNO
Should be Empty: