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Discovery Call For Personal Coaching
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Email
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Your email
Your first and last name
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Your answer
Best Phone Number to Reach You
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Your answer
Your Marital Status
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Single
Living Together
Married
Divorced
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Please list names and ages of children:
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Your answer
What is your biggest parenting problem right now?
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Your answer
How long has this been bothering you?
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Since birth
Since toddler
Since school-age
Other
Which of the following is most affected by this problem?
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Marriage/partnership
Relationships with siblings/other children
Relationships with other adults (grandparents, teachers, etc.)
General home atmosphere
School
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On a scale of 1-10 how important is it to you to make a change?
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5
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7
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10
If we could work together to solve this problem, what would your life look like?
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What is the best time of day to reach you?
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How did you hear about me? And, is there anything else you'd like for me to know before we chat?
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