Business Coaching Request Form

Schedule Your Breakthrough Strategy Session

Are you ready to take Charge of your Destiny and Finances and create a life filled with Purpose, Destiny and Financial Wellness?
Hello I'm Dr. Juanita

I am so excited you have made the 1st “Gear Shift” towards achieving your “Life of Destiny and Financial Freedom” by joining in on this Journey. You have made a significant DECISION that will change the trajectory of your life and legacy. This is a DEFINING moment in your DESTINY.
Name*

First NameLast Name
Confirm E-mail*
Phone Number*

Area CodePhone Number
What are your top three CHALLENGES you want to overcome?*
What are your 3 personal, professional and financial goals?*
What SPECIFICALLY is stopping you from hitting these goals?*
What is your bold money goal for 2025?*
What would it mean to you to reach this goal? How would your life be different?*
What FEARS do you have around your challenges?*
What have you been taught about what it means to dream and finances?*
Are you currently enrolled with a coach or completing any programs/ any previous financial coaching?*
Why SPECIFICALLY do you feel you need a coach?*
Why do you feel Dr. Juanita is the right coach for you?*
How ready and willing are you to INVEST in yourself and your financial future? (Time, dedication, financial resources)?*
Are you willing to do what it takes, to challenge yourself, to get OUT of your comfort zone, eliminate excuses and be unstoppable towards your own success?*

Yes!No
About your financial resources & willingness to invest...*

I have the financial resources to invest in myself right nowI can generate the financial resources to invest in myself as I go, but don't have all of the money in hand right nowI don't have the financial resources to invest in myself any time soon
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Schedule Your Breakthrough Strategy Session

Hello I'm Dr. Juanita