Legacy Impact Coaching Application
We are looking forward to helping you reach your goals with focus and clarity. This assessment will help us determine the best approach to reaching your goals quickly. After you complete the assessment, we will arrange a Discovery Session to discuss a plan of action.
Sign in to Google to save your progress. Learn more
Email *
First & Last Name *
Spouse's Name *
Phone number *
How long have you been married? *
Will you be doing the coaching alone or with your spouse? *
On a scale from 1 to 10 how would you rate your marriage? *
Struggling & Shaky
Thriving & Strong
What areas in your marriage are you struggling in and looking to get help? *
What have you tried? *
Besides yourself, who or what is being impacted by your struggles? *
Why do you feel it's important to have a coach now? *
What have been your three greatest successes to date? *
Are there other things your want to share about you marriage or situation? *
Tell us the vision for your marriage. How do you want it to be 12 months from now? *
Are you aware there are time commitments and fees associated with working with us to help you achieve the marriage of your dreams? *
How did you find us? *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy