True Self Coaching Questionnaire

True Self Coaching Questionnaire

I appreciate your interest in learning more about one-on-one coaching.
You're here because something needs to change — how you breathe, how you handle stress, how you show up. This is where that starts. Please take a couple minutes to answer a few quick questions so Justin can understand where you are, what you're looking for, and how we can best work together.

Upon completing this form, you will receive a follow up email with a link to book your discovery call to connect and answer any questions you may have before beginning our work together.
PERSONAL DETAILS
Name*

First NameLast Name
Email*
example@example.com
Where are you located?*
COACHING INFORMATION
What is the main issue(s) that I can help you with? *
On a scale of 1 to 10, how much stress do you experience on a daily basis?*

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1 is Minimally Stressed, 10 is Severely Stressed
On a scale of 1 to 10, how would you rate your quality of breath?*

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1 is Very Poor, 10 is Excellent
On a scale of 1 to 10, how would you rate your overall quality of health?*

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1 is Very Poor, 10 is Excellent
Please describe an ideal outcome that you aim to achieve in working together?*
COACHING PACKAGES:

5-Week Reset - $800 | 5 Weekly Sessions aimed to support you in resetting your mind-body and nervous system.
3-Month Growth - $1,299* | Looking for continuous growth and support? This is a great plan that builds on the foundation of breath.
6-Month Transformation - $2,299* | This program is for those looking to take their practices to another level. Transform in mind, body, spirit. I got you.

*3 & 6-Month Packages includes premium access to online courses, our online community, and more! Payment plans available.
What Happens Next?
Check your inbox! You'll receive a link to schedule your free discovery call. During this call, we'll explore your goals, answer your questions, and create a personalized roadmap for your transformation.
Thank you for trusting me with the opportunity to work together. I look forward to connecting with you, learning about your story, and supporting you on your journey towards your truest version of self.

— Dr. Justin Ternes
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True Self Coaching Questionnaire

PERSONAL DETAILS

COACHING INFORMATION

COACHING PACKAGES: