Level Up With Mitch – Apply Now
Name
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First Name
Last Name
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Phone Number
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What brought you here? (Select all that apply)
I feel stuck or unfulfilled and don’t know why
I want to level up
I’m tired of doing it all alone
I’m ready to face what’s been holding me back
I want structure, guidance, and accountability
I’ve seen Mitch’s content and felt called to reach out
I am struggling with addictions
Other - Please specify below
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What are the biggest challenges you are facing? (Select all that apply)
Lack of purpose/direction in life
Poor Mental Health
Physical health/fitness struggles
Relationship struggles (romantic, friendships, family)
Confidence/self-worth struggles
Financial/career stagnation
Lack of discipline & motivation
Addictive Behaviours
Other
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How long have you been experiencing these challenges?
Days
Weeks
Months
Years
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Have you tried any solutions before? If so, what worked and what didn’t?
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Are you currently experiencing any strong attachments, dependencies, or coping habits related to the following?
Pornography
Alcohol
Recreational drugs
Smoking - Vaping or Cigarettes
Doom Scrolling
Toxic/casual relationships
Other - If you feel comfortable, share anything you’d like to add or expand on below
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What do you want to achieve in the next 3-6 months?
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What is stopping you from achieving this right now?
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To understand where you at, How ready are you to change NOW?
25% – I’m just starting to explore and not sure if I’m ready to take the leap yet.
50% – I’m interested in change, but not sure I’m ready to fully commit yet.
75% – I’m committed and motivated, but I still have some fears or doubts I’m working through.
100% – I’m all in
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Do you have any hesitations to coaching? (if so, what in particular)
I really appreciate you sharing what’s been going on for you, thank you for your honesty.
Press submit to lock in your spot and book a free call with me.
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