Questionnaire

To make sure I can fully support you during your 'Breakthrough Session', please complete the form below prior to booking your call.
Upon submission, you will be directed to my online calendar to schedule your free 45-minute 'Breakthrough Session'.

* Indicates required field

1. What is your name? (First & Last) *

First

Last

2. Phone number: *

3. Email Address: *

4. Please tell me about you & share WHY you are brilliant at what you do! *

5. What is your current and biggest struggle? *

Relationships Health & Wellness (Physical / Emotional) Work / Finances

6. What is the biggest challenge for you here? *

7. What is the big result you would love to receive in working together and why is achieving this important to you? *

8. Why is now the perfect time to invest in yourself and go for your goals? *

9. I will only schedule calls with people who I know I can truly help. Is there anything that you would like me to know when considering your application? *

10. Why me? What has you reaching out to work specifically with me? *

11. On a scale of 1 to Bruce Lee, how awesome are you?! *

Declaration(s):
* You are coachable and open to feedback.
* You have a true intention to be of service and uplift others.
* You are ready to take action and grow outside of your comfort zone.
* You are open to feedback and willing to see your life from a new perspective.
* You are dedicated to learning and implemention because showing up fully for yourself is the best way to serve others.
* You are willing to invest in yourself and your health to move forward and get the results you want.

This not a commitment, I just need to know if you are serious about achieving your goals. *

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I agree to receiving marketing and promotional materials

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