Request edit access
Application to have a discovery with Tina
Please fill in the following questions with complete answers to help make the discovery call as best as possible.
Sign in to Google to save your progress. Learn more
Full Name *
Phone Number + Skype ID *
Country of residence *
How long are you in this situation you are currently dealing with? *
How much does this problem effect you at the moment on a scale from 1 - 10? *
not too much
very much
What is the most challenging part for you? Please describe your problem briefly: *
What was the turnover for you to ask for support? What would it mean for you if this changes? What are your goals on this? *
Please name 3 other goals in your life, that you have independently: *
5. What is your budget for getting help with this? *
I hereby confirm that I am pyhsically and mentally healthy. *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report