Full Program Subscription Cancellation Request
Once you submit this form, your subscription will be cancelled, and you will not be charged for the next monthly period. Please be aware that if you subscribed at the introductory discount price, THIS PRICE WILL NOT BE AVAILABLE for re-entry, should you decide to re-join the program later.
Requester Information
Full Name
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First Name
Last Name
Email Address
*
example@example.com
Program Goal and Commitment
What ultimate dream or end goal did you originally want this program to help you achieve?
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Are you still committed to achieving this ultimate dream/end goal?
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Yes, fully committed
Somewhat committed
I’m unsure
No, my goal has changed
Cancellation Reason and Step 1 Reflection
What is the main reason you are requesting cancellation of the full program subscription?
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I did not have time for the program
Things did not work out as expected
The program was confusing
I did not complete the required actions
I completed the required actions but did not see enough progress
I lost motivation
The goal no longer feels important to me
Financial reasons
Other
Before cancelling, have you considered that Step 1 was designed as a stepping stone toward your larger dream, not the full destination by itself?
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Yes
No
I’m not sure
Step 1 Completion Details
Which Step 1 required actions did you complete? (Select all that apply.)
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I reviewed the Step 1 instructions/materials
I followed the daily/weekly action plan
I tracked the required information or progress
I completed the assigned check-ins/reflections
I asked for help when I was stuck
I applied the recommended changes consistently
I did not complete any of the required actions
Other
Which Step 1 required actions did you not complete, and what got in the way?
How consistently did you complete the required actions in Step 1?
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Every day or almost every day
Several times per week
About once per week
Rarely
I did not start
Roadblock and Support Options
What is the biggest roadblock you’re facing right now as you think about your larger dream?
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Would working with me 1-on-1 in resolving this obstacle help you move past this roadblock — assuming this help is free of charge?
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Yes, I would like free 1-on-1 help before cancelling
Maybe, I would like to discuss it
No, I still want to cancel
I’m not sure
Have you found any other realistic approach that you believe can help you achieve this same ultimate dream?
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Yes
No
I’m not sure
If yes, please briefly describe the other approach you plan to use (optional).
Future Plan, Support, and Consent
If you cancel now, what is your plan for achieving the ultimate dream you originally set?
What support, clarification, or adjustment would have made it easier for you to continue?
Would you like us to contact you before processing the cancellation to see whether this obstacle can be resolved?
Yes, please contact me
No, please process my cancellation
I’m not sure
I understand that I may request cancellation for any reason, and that this form is intended to help identify whether my current obstacle can be resolved before I give up on the ultimate dream I originally set.
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I understand and agree
Submit Full Program Cancellation Request
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