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Discovery Call Form for Confusion to Clarity 
Discovery call Form for Confusion to Clarity
Hello & Welcome to this Discovery call to achieve your desired state.
Congratulations for being an Action Taker. This shows your commitment towards your growth.
Please fill the below form with honesty.
After this form is analysed, we will understand your requirements and get back to you with a clarity call of 30-40 Minutes, where I get to interact with you and get to know you! This is a safe platform where you can share about where you are currently stuck in life and I will help you begin your life transformational journey. Your data and privacy will be intact.

Book your slot now by filling up this simple form and I shall soon reach out to you!! 

* Indicates required question
Email *
Full Name *
Whatsapp Number *
Email ID *
City *
Age *
Profession (Job, Business, Self Employed) *
Gender *
Please let me know , in which area of life I can help you?
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Required
On a scale of 1 to 10, how would you rate your overall emotional well-being right now? *
What are the top 3 emotions you've been experiencing lately? *
Describe in brief where you are currently stuck in your life or what challenge(s) you are currently facing.  For how long have you been facing the issue? *
Have you ever been diagnosed with any mental health disorders (e.g., depression, anxiety, PTSD, ADHD etc) *
Are you taking any medicines or solutions currently for that issue or any mental health issues?
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Do you find yourself delaying or procrastinating tasks? *
Do you have any physical health condition that maybe affecting your emotional well-being? List them. *
Rate yourself on how you think about yourself, 1 being never enough and 10 being simply fabulous *
How would you describe your sleep quality or quantity? *
Do you experience any difficulties falling asleep or staying asleep? *
How would you rate your energy levels throughout the day on a scale of 1 to 10 (1 being lethargic and 10 being super energetic) *
Do you experience racing thoughts or difficulty quieting your mind?
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Have you experienced any significant traumas or adverse life events in the past?
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Do you feel that these experiences continue to impact your emotional well-being?
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Do you experience any recurring memories, flashbacks, or nightmares related to past traumatic events?
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How do you typically react when reminded of these traumatic experiences?
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Are you able to say NO to people and set healthy boundaries with them?
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Would you describe yourself as 
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Who was emotionally most available for you during your childhood?
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Select the statements to which you agree the most: 
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Required
Do you feel suicidal?
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What's your #1 reason for booking this session and what would you like to accomplish through Emotional and Wellness Coaching?
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Be 100% Honest and tell us where do you feel you are lacking behind or What is stopping you to achieve what you want ?   (The more specific you are here the faster we'll get you clarity during our call together)
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Have you tried anything in past to resolve your issue?
Please share in details
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If You get Exact blueprint or solutions to resolve your issue how much you are willing to invest for self-development or to solve this issue?
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Do you confirm 100% that you'll be available for the call at the selected date and time in a noise-free environment with proper internet and a clean sheet of paper to take notes?
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