First Name *

Last Name *

Email *

Phone *

Date of birth *

Preferred Contact Method: *

Preferred Start Date: *

What are your main reasons for seeking coaching? *

How has this issue impacted your life? *

How would your life be different if this issue were resolved? *

What have you done so far to help remedy your issue? *

How will you know when we have succeeded in accomplishing the objective? How will you feel differently? What will your life be like? *

Have you worked with a coach before? If yes, what was your experience? What did you like and not like? *

My coaching programs are results oriented. To be able to get the results you seek, you must be able to take full accountability for everything in your life. You must understand that you chose everything you experience to provide your soul the lessons it needs to evolve.

Are you willing to take complete ownership over everything in your life? Do you commit to NOT placing blame on other people or circumstances? *

Yes

No

Are you completely committed to resolving this issue? Are you willing to do the homework we agree on, such as journaling prompts, trigger diary, etc. *

Yes

No

Have you ever worked with the subconscious/unconscious mind before? *

Yes

No

Do you believe in past lives? Or are you open to the possibility of past lives? *

Yes

No

Are you comfortable with identifying and listening to your intuition? *

Yes

No

Getting the kind of results you're looking for would require an investment of time, presence and finances. Is this something you're prepared to do right now? *

Yes

No

My coaching programs consist of 6-20 sessions, with each session designed to deliver immediate transformation. If we discover that working together is the right fit for you at this moment, what level of investment are you ready to commit to in order to achieve the results you desire? *

"Reveal Your Natural Bliss" meeting 2x/week for 10 weeks $9997

"Paradigm Shift" meeting once a week for 8 weeks $4997

"Breakthrough" meeting once a week for 5 weeks $2222

Other

If you selected Other, Please explain.

Is there anything else you would like me to know?

How did you hear about me?

Thank you for reaching out to learn more about how personal mastery can benefit you personally. I am delighted to share the prospect of releasing your limitations and being able to nurture a life you are passionate about. A new life full of possibility and promise is just on the other side of this introduction.

By completing this form you will be directed to set an appointment to discuss next steps.

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