Virtual Accountability Coaching Application
Complete this application to be considered for virtual Accountability Coaching with Coach Daphne. We will contact you within 1-3 business days with the determination of your application. If you have any questions or concerns prior to receiving the determination, please email admin@drbeard7.com.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
How did you hear about Accountability Coaching?
Instagram
Facebook
Email
Word of Mouth
Other
What time zone are you in?
*
What are your social media handles?
What's the main reason you are applying for Accountability Coaching?
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Have you invested in Accountability Coaching before? If so, which ones and what were your results? If no, type N/A.
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Accountability Plans range from $79.99/month- $399.99/month depending on what plan you select. Are you able to afford coaching at this time?
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Yes, I'm able to invest in coaching now
No, I cannot afford coaching at this time
Maybe, I might need more time to prepare to invest in coaching
If approved for Accountability Coaching, when would you like to start?
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Month
-
Day
Year
Date
What are your life goals you want to achieve within the next 6 months? (Please list short and/or long-term)
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What are your expectations of having an Accountability Coach?
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What is happening (or not happening) with your life goals that is causing you to apply for accountability coaching?
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Is there anything else you'd like to add? If no, type "N/A"
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By signing your name you attest that all information provided here is true and correct to the best of your knowledge. If yes, please sign your first and last name here:
*
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