Fear It Goes
Your Aligned Mapping Session
Our Promise To You
All Information provided on this form is highly confidential and treated with the utmost respect. We share this with NO ONE. We do no SHAME, GUILT or JUDGE ANY ANSWERS you fill in below so please be honest and answer with as much details as possible for your answers. The sole purpose for this information is to understand your big picture, where you are currently, how, and where you may need help.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What do you do, and what does success look like for you right now?
*
Imagine for a moment, if we could wave a magic wand what changes would you like to see in your life in the next twelve weeks? Don't hold back.
What are the biggest struggles you are having right now? The more details the better prepared we are for your call.
With 1 being not very and 5 feeling really stuck, where would you rank your situation?
Not Really
1
2
3
4
Very Stuck
5
1 is Not Really, 5 is Very Stuck
Be 100% honest. What's holding you back from reaching your ideal situation? Do you recognize any recurring behavioural patterns in your relationships? If so, what are they, who are they with, and how are you adding to it? There is no judgment here, only details to get the larger picture. Please give details.
Do you feel your situation is costing you? Financially? Emotionally? Physically? Time? Energy? (Is this affecting family relationships? Career? Friends? Living life or going into hiding?)
What solutions have you sought out in the past, and how well did they work for you? (ie. books, counsellors, therapists, coaches, medications)
If you could change this, what would this FREEDOM mean for you and your life? Close your eyes and imagine for a moment. Write everything you can think of that would improve. (Only include the way you would like to see your life not the reason why you are NOT experiencing it, we work through that in the process. This question is meant only for the FREEDOM you see on the other side of these issues).
Right Now
I have the financial resources to invest in myself
I have access to financial resources to invest in myself
I don't have the financial resources at all and I'm going to keep things as they are
On a scale of 1 to 10, where would you rate your Deserving Self? Do you feel you deserve a great life? Great family? Great friendships? Great career? Great love? Honesty is important here.
Before you apply
I understand the Aligned Mapping Session is for high performers and high achievers. It is not for addiction recovery or crisis support. If you need that kind of help, please contact a qualified professional or local crisis line.
*
If this turns out to be the right fit, are you open to investing in working together?
*
Yes
Not sure yet
No
How committed, open, and willing are you to create new habits over the next twelve weeks so you can experience FREEDOM and finally live the life you really want with joy and ease?
25-50%
50-80%
80-00%
If I invite you to book an Aligned Mapping Session, I will call you at the time you choose. Please commit to showing up by typing this sentence in the box: "YES, I PROMISE TO ANSWER THE CALL FOR MY ALIGNED MAPPING SESSION"
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