RECLAIM FORM

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Linked In or Social Media Handle
4
Why do you want to work with a coach?
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Ok
Ok
5
If anything was possible right now, what would your life look like? What is your hearts desires?
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Ok
Ok
6
Where do you see yourself in 6 months from now? 1 year? 5 years? 10 years?Think about how you want to feel and what the tapestry of the daily fabric of your life.
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Ok
Ok
7
What are the biggest challenges you are currently facing in your life and/or business/work?
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Ok
Ok
8
What are your 3 biggest goals for this year?
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Ok
9
What is stopping you from achieving these things?
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Ok
10
What might you have to sacrifice to make these goals a reality?
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Ok
11
Working together will require an investment of time, energy & finance. Are you ready to make this kind of investment in yourself?
YES
NO
12
RECLAIM is an investment of 6000 GBP / $7500 - Is this within your means?Payment plans fees available upon request.
YESNO
Should be Empty: