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Question 1 of 16
First Name:
Question 2 of 16
Last Name:
Question 3 of 16
Email:
Question 4 of 16
Best phone number to contact you?
Question 5 of 16
Name of Business (if applicable):
Question 6 of 16
What is your full birthdate? MM/ DD/ YR
Question 7 of 16
Where were you born? EXACT time you were born? (please include AM or PM)
County, City, State:
Time:
Question 8 of 16
Where do you feel like you need support in your life? in your business?
Question 9 of 16
What do you currently feel are your greatest strengths in your life? in your business?
Question 10 of 16
What do you currently feel are your greatest challenges in your life? in your business?
Question 11 of 16
If you could wave your magic wand, what would success look like for you from your coaching with me?
Question 12 of 16
Do you have a "coaching budget" you are willing to invest in yourself to get the results you desire?
$100-$200 per month
$200-$400 per month
$400-$600 per month
$600-$800 per month
$800 + per month
No, I haven't thought about it.
Question 13 of 16
From the items below, what would you like to know more about?
Creating Clarity in Your Goals
Communication Skills/ Speaking Your Truth
Consultation Skills
Client Retention Strategies
Create an Education Program
Emotional Intelligence- Understanding your emotions
Healthy Boundaries
Leadership Skills
Money Management/ Money Mindset
Pre-Booking & Add-on Services
Professionalism/ Work Ethics
Recruiting and Developing Staff Members
Retirement/ Exit Strategy
Self Confidence
Self Care Strategies
Social Media Skills
Strengthen Relationships (friends, family, partners, business partners)
Time Management (Work/Life Balance)
Team Building
Work/ Life Balance
Human Design- Tell me more!
Women's Retreat- Tell me More!
Reiki Healing/ Session- Tell me more!
Question 14 of 16
Please share any other details you would like for me to know.
Question 15 of 16
Who can I thank for referring you to me?
Question 16 of 16
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