Your Full Name
*
First Name
Last Name
Your Email
*
example@example.com
What is the area of your life you want to improve MOST and focus on right now?
*
Finances (money, work, business)
Health & Wellness (Physical, Mental, Emotional, Spiritual Wellbeing)
Relationships (happier, more fulfilling, deep and authentic connections)
Life Satisfaction (more energy, healthier attitude and perspective)
Career Alignment and Fulfillment
Your current challenge is -
*
Lack of Clarity
No strategy, vision or plan of action
Energy management (tired, exhausted, no motivation)
Lack of confidence
Unsupportive relationship (example, in brink of divorce)
Psychological barrier (example, procrastination)
Emotional rollercoaster (example, from deep sadness to rage)
Financial blocks (example, feast or famine)
Addiction
Other
Any other challenges and fear that could be holding you back?
*
How long have you been struggling with these challenges?
*
What is holding you back from making the changes you want for yourself?
*
How do you feel about where you currently are in this area of life?
*
I desperately need change. I feel I'm drowning. I am so stuck. This sense of powerlessness is making me scared, anxious, and depressed
I can't live like this. I am very unhappy, unsatisfied, and becoming more and more insecure that I can't stand it any longer.
I realize I need to change, but I am managing fine for now.
Even tho I am unhappy and could do much better, there's nothing I can do right now, and have come to terms with where I am at right now.
Explain why this change is (or is not) important now
*
From 0-10, how committed are you to breaking through? 0=not at all, 10=100%
*
How much time are you willing and able to invest in creating your desired outcome?
*
1-2 hours a week
2-4 hours a week
5+ hours a week
What Financial investment are you able and willing to set aside towards creating your desired results?
*
$200-400 a month
$400-500 a month
$500-1000 a month
$1000-3000 a month
Have you worked with any of the following before?
*
Counselling
Psychotherapy
Energy Healing
Hypnotherapy
Coaching
None of the Above
Other
Is there anything else you would like to share to make this coaching conversation a mind-blowing, life-transforming, soul enlightening experience for you?
Submit
Should be Empty: