Exploratory Form
Email address *
Full Name: *
Your answer
Cell #: Country Code, Area Code, Number *
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Email Address: *
Your answer
What was your drug of choice and how long do you have sober? *
Your answer
What type of treatments have you experienced in the past? (inpatient, outpatient, IOP, 12 Steps, other) *
Your answer
What has worked to keep you sober? What has not? *
Your answer
If you have relapsed in the past, how many times and how did you get back to sobriety? *
Your answer
What area of your life feels more "off" than the others and why? * *
Your answer
What area of your life feels the most "ON" or "In Flow"? How do you think you have achieved this? *
Your answer
If you were able to unlock your potential what would that look like in 12 months time ? *
Your answer
What is blocking you from having that right now? *
Your answer
Have you worked with a coach in the past and if so, what changed for you? *
Your answer
Why do you think I am potentially the right coach for you? *
Your answer
I am ready & willing to make an investment of time & money to my transformation (Powerful conversations are reserved for those ready to make an investment on the call) *
Yes. I have the ability to invest now.
Yes. If I had the option of a monthly payment plan.
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Anything else I should know?
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