Request edit access
Bara Sapir's Full Potential Strategy Session Pre-Chat Information Form
Hi there! So great to see you made it over here. I'm excited to speak with you to discuss actionable steps you can take to move towards your goal - - whether that's earning top score on a high stakes tests, releasing test anxiety, or changing habits that no longer serve you. Before we talk, I'd love to learn a little more about you to make our time together helpful and efficient. Fill this out, and at the end you'll find the link to set up our 15-minute Full Potential Strategy Session! Thanks!

I can't wait to share catalysts and sure fire methods you can make to meet your goals and manifest your dreams.

Until soon!

Email address *
Name/Nickname *
Your answer
Where do you live? (city/country)
Your answer
Phone Number *
Your answer
Skype ID for those out of the USA
Your answer
How did you hear about this strategy session - - webinar, talk, lecture...please include webinar name, date and if it was a referral.
Your answer
What goal(s) are you seeking to meet/dream desiring to fulfill?
Your answer
How did you hear of me? *
If taking a test, what test and when is your test date? *
What are you top three challenges or blocks related to your goals and dreams
Your answer
Do you have feel anxiety or worry? *
What else is else bothering you? Even a little.
Your answer
What are you doing or plan to do to improve your situation? *
Your answer
Have you ever used holistic or mindful techniques?
If yes, what have you done and how did it help?
Your answer
If preparing for a test: How do you study? How are you preparing for your test? (Pick the one that is more pressing). *
What are you hoping for in our conversation? *
Your answer
What is your timeline in wanting to work on your goal?
Are you willing to invest in mentor or coach for support? *
Is there anything I have not asked that you feel I should know?
Your answer
Awesome! Great job! All done!
Now set up your 15-minute time with me here: If none of the times offered work, reach out to me directly at

Looking forward to helping you make shifts and changes for good!

Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy