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Please answer these few questions so I can get to know you better.
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1
Name
What is your name?
First Name
Last Name
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2
Age
How old are you?
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3
Email
What is your email address?
example@example.com
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4
Phone Number
What is your phone number?
Area Code
Phone Number
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5
Social Anxiety
(Current Level)
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5
Low Anxiety
High Anxiety
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6
Social Skills
(Current Level)
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2
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5
Bad Social Skills
Good Social Skills
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7
How often do negative thoughts affect your daily life?
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Often
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8
How is social anxiety and negative thinking impacting your life currently?
(Be Specific)
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9
What are the biggest challenges you face in shifting your mindset to positive thinking?
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10
Have you ever tried meditations, affirmations, or visualization?
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NO
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11
If yes, what has worked for you?
Meditation
Affirmations
Visualization
Other
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12
Are you prepared to invest in a program that could help you overcome your social anxiety?
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13
Why do you believe that now is the best time for you to conquer your social anxiety?
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14
What are you looking to get out of our 1-on-1 coaching?
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