Application for Your Free 30-minute Consult Call with Daria Nicomedi, Your Personal Leadership Coach

Welcome!

If you've come this far, I deeply admire you for choosing to take the time to develop in one or more areas of your life. It takes a great deal of self-awareness and courage to take the first step!

Below you will find the questionnaire, which precedes the free 30-minute consult and Skype Introductory call, and which I invite you to fill out carefully.

How does the questionnaire help us both?
- It clarifies your reasons and motivations for contacting me.
- It allows us to understand if we're a good fit and how I can actually help you, through the program, to achieve your goals.

Please note:
- Everything you write will be held to the utmost confidentiality, read only by the undersigned.
- Answering as honestly and specifically as possible makes this all the more useful for both of us.

And with that, let's begin!

Daria Nicomedi
Founder of the Darius Academy

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Name and Last Name *
Email *
City and Country *
Contact Number *
How did you hear about me? *
What motivated you to consider this course? *
What have you tried so far that has not worked? *
Have you been to other professionals to help you? (psychologist, life coach, counsellor, etc.) *
Have you been to other professionals to help you? (psychologist, life coach, counsellor, etc.) *
If so, what has been the financial and time investment that you have made so far?
What goals would you like to achieve from this course? *
What has prevented you from achieving this so far? *
I have worked hard on this program and I am only interested in working with people who are really willing to put themselves out there to get what they need. How motivated do you feel, from 1 to 10, to embark on a journey of real change? *
Not at all motivated
Highly motivated
Do you have the resources available to invest in course of valuable transformation? *
If the course were to lead you to your goals, when would you like to start? *
I authorise the processing of my personal data in accordance with Legislative Decree 196 of 30 June 2003 and EU Regulation 2016/679 (GDPR). Your data will never be given, disclosed, or sold for any reason. *
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