5 Days to Clarity, Momentum & Confidence

1

Your Full Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number* This field is required.

4

Where are you currently in your coaching or healing business journey?* This field is required.

I haven’t started yet, but I know I’m called to help others.

I’ve started sharing my work, but I’m not consistent or clear on how to grow.

I’m actively working with clients but feel stuck or undercharging.

Established, but looking to scale beyond $10k/month

5

How long have you been working on your business (or serious about starting it)?* This field is required.

0–6 months

6–12 months

1–2 years

Over 2 years

6

What’s your single biggest challenge right now in growing (or starting) your business?* This field is required.

Fear of change/Loosing my income

Not sure what busines to start

Not sure where to start

I get stuck showing up online

Fear of charging

Clarifying my niche

Don’t know how to structure my offer

Confidence

Attracting clients

7

Have you tried any strategies, coaching, or courses to overcome this challenge before?* This field is required.e.g. “Attracting clients,” “Building confidence,” “Clarifying my niche,” “Scaling my offers,” etc.

YESNO

8

If yes, which ones, and how did they help (or not help)?Leave if not applicable

9

Why is success in your business important to you right now?* This field is required.Short Answer: e.g. “I want financial freedom,” “I crave purpose,” “I want more time with family.”

10

If everything aligned, what would your dream monthly income look like?* This field is required.

Under $3k

$3k–$5k

$5k–$10k

Above $10k

11

On a scale of 1–5, how important is it for you to fix your current challenge now rather than later?Rating Scale (0 = Not urgent, 5 = Extremely urgent)

12

How willing are you to invest (time, energy, finances) in getting the right support to grow?Rating Scale (0 = Not at all, 5 = Fully committed)

13

What might hold you back from taking action, even if you want to?* This field is required.e.g. finances, time, mindset, etc.

14

If support was available to help you grow, when would you want to begin?* This field is required.Please Choose One

Immediately

Within 1 month

Within 3 months

I’m just exploring options for the future

15

Where do you see yourself 12 months from now if you had the right strategy and support?* This field is required.Short Answer:

16

Any other specific information you’d like to share about your goals or challenges?* This field is required.

17

Your Workshop Start Date* This field is required.💡 Next Workshop Date is the 14th of Jun 2025 9AM AEST

Date