There's just one more step before getting started with "Jumpstart Coaching"!
Hello there! I want to make sure your investment in my 8-week "Jumpstart Coaching" program will be a good fit for both of us. So, I'd like to ask you to answer the questions below to help me understand a little bit more about what you are looking for. You can answer in as much detail as you'd like.

I will review your responses within one business day and send you a link to complete your registration with your payment.

The information you enter here will be considered confidential.

In the meantime, if you have any questions, or if you'd like to schedule a call with me, please email me at: Kay at

Email address *
Tell me a little about you. *
Your answer
Tell me about one specific problem or situation you are facing that you'd like to discuss with me. *
Your answer
Your name (first and last) - please include your preferred name, as well, if you don't go by your first name. *
Your answer
Your best phone number and time zone. *
Your answer
Your preferred email address, if different from the email you entered at the top of this form.
Your answer
Thank you! Again, you can reach me at Kay at if you have any questions.
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