Fear It Goes
Your ALIGNED IMPACT MAPPING SESSION
Our Promise To You
All Information provided on this form is highly confidential and treated with the utmost respect. We share this with NO ONE. We do no SHAME, GUILT or JUDGE ANY ANSWERS you fill in below so please be honest and answer with as much details as possible for your answers. The sole purpose for this information is to understand your big picture, where you are currently, how, and where you may need help.
Name
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Last Name
Email
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Phone Number
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Format: (000) 000-0000.
Imagine for a moment, if we could wave a magic wand what changes would you like to see in the next twelve weeks? Don't hold back.
What are the biggest struggles you are having right now? The more details the better prepared we are for your call.
With 1 being not very and 5 feeling really stuck, where would you rank your situation?
Not Really
1
2
3
4
Very Stuck
5
1 is Not Really, 5 is Very Stuck
Be 100% honest. What's holding you back from reaching your ideal situation? Do you recognize any recurring behavioural patterns in your relationships? If so, what are they, who are they with, and how are you adding to it? There is no judgment here, only details to get the larger picture. Please give details.
Do you feel your situation is costing you? Financially? Emotionally? Physically? Time? Energy? (Is this affecting family relationships? Career? Friends? Living life or going into hiding?)
What solutions have you sought out in the past, and how well did they work for you? (ie. books, courses, coach, mentor, counsellors)
If you could change the above, what would this meaningful LEGACY mean for you and your life? Close your eyes and imagine for a moment. Write everything you can think of that would improve and that you could create without limits. (Only include the way you would like to see your life not the reason why you are in it, we work through that in the process. This question is meant only for the LEGACY you see on the other side of any limits).
Right Now
I have the financial resources to invest in myself
I have access to financial resources to invest in myself
I don't have the financial resources at all and I'm going to keep things as they are
Legacy encompasses many areas. On a scale of 1 to 10, where would you rate your Legacy? Do you see yourself with no regrets? A great life? Great family? Great friendships? Great love? And the LEGACY for generations to come?
How committed, open, and willing are you to create new habits over the next twelve weeks so you can experience Deep Meaningful Aligned Impact and finally live the life you really want with joy and ease?
25-50%
50-80%
80-00%
Our team will call you at the time you chose. Please commit t your appointment by typing this sentence in the box. "YES, I PROMISE TO ANSWER THE CALL FOR MY ALIGNED IMPACT MAPPING SESSION"
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