You can be professionally successful, have a deep and exciting love life AND be personally fulfilled.
I commend your willing to take a closer look at your life and how satisfied you are with the success and love you have in your life.

To see if we would be a fit to have a conversation, please take a few minutes to answer the questions below. I will follow up in a couple days to schedule a consultation or recommend an alternative resource.

Personal Details
Name: *
Your answer
Age:
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Relationship Status:
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Email (Please check spelling): *
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Best Phone: *
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State/Province/Country:
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How did you find me? *
Your answer
1) Rate each of the following Attraction/Relationship areas, from 1- 5 *
1 is hardly ever. 5 is you can't imagine this could possibly be any better. I'm not judging you, so please be honest. It's the only way to get where you want to be.
1
2
3
4
5
I feel great/confident about myself
I feel centered, clear & on purpose in my life and work
I know what I want with women and feel right/good about my desires
I feel free to ask for what I want/need with women, sexually and otherwise
I am getting the affection, connection and sex I really want with women
I appreciate and respect women. I care about them as human beings
I have access to my emotions and feel "embodied"
My relationships with other men are honest and a great support in my life
I feel vital and inspired throughout the day
My income matches the financial picture I have for myself
I have the impact I want to have on the world
I am acting on the dreams and visions that are important to me
2) Which of the areas above do you most want change in over the next 6-12 months? *
Your answer
3) Describe what your connections and relationships with women would be like if there was nothing limiting you or holding your back... *
Your answer
3) Describe what your career, impact and income would be like if there was nothing limiting you or holding your back... *
Your answer
4. What three things are you most tolerating or putting up with in your life? *
Your answer
Which of these are you ready to handle? *
Your answer
5) Assuming all human beings have some way of holding back or sabotaging our lives, which are your favorite methods? *
Required
6) What would you get from coaching that would be most valuable to you? (Choose up to 3)
7) How coachable (open to input and feedback and ready to make changes) do you suspect you are? *
8) Primary Interest: *
What else do you want me to know?
Your answer
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