Name
First Name
Last Name
E-mail
example@example.com
Phone Number
-
Area Code
Phone Number
When calculating your daily "Mode" right now, which best describes you?
A) Survival Mode: Everything feels like a fight—drained, reactive, just getting by.
B) Grind Mode: Hustling hard, but it's wearing me down; output over ease.
C) Alignment Mode: Starting to sync up—some flow, but inconsistencies pull me back.
D) Flow State: Locked in—decisions feel guided, energy sustains effortlessly.
What's holding you back most from living in alignment? (select all that apply)
A) Overwhelm from endless to-dos and distractions (e.g., social media, busyness).
B) Doubt about my identity—who am I beyond the achievements?
C) External pressures (work, relationships) that drown out my intuition.
D. Other
How prepared are you to make an investment into the transformation you're looking for (1 being 'not right now' 5 being 'I need to change lets do this')
1
2
3
4
5
Have you tried anything before to break the grind cycle (e.g., coaching, books, retreats)?
A) Yes, and it helped somewhat—gained tools but need deeper accountability.
B) Yes, but it didn't stick—life pulled me back in.
C) No, this feels like the right first step.
What shift in your life are you looking for? Paint the picture in 1-2 sentences.
Roughly how much time do you spend daily on habits that you would consider draining to your energy? (scrolling, numbing, overworking)?
A) 4+ hours—it's autopilot.
B) 2-4 hours—manageable but creeping up.
C) 1-2 hours—mostly intentional breaks.
D) Under 1 hour—I'm mindful but room to tighten.
Why From the Cross specifically? What about identity rooted in something bigger resonates with you right now?
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