Private Coaching
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Email *
Name *
First and last name
Phone number *
City, Country *
What is your age? *
Are you currently working with a coach or enrolled in any personal and/or business development programs? Please let me know of any coaching and/or training you have recently completed. *
Why are you seeking coaching at this time? *
What is your #1 intention in booking a consultation with me?
Which area(s) of your life are you primarily interested in improving? (please select all that apply) *
What do you want to accomplish as a result of having me coach you? What is your BIG vision? *
Do you understand that it is your responsibility to fully commit, do the work required, and that your success essentially relies upon you? *
Do you understand that working with me means a significant financial commitment?
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Who typically makes the decisions when it comes to investing in your future?
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Are you the type of person who makes excuses, blames others for your misfortunes, or typically doesn't finish what they start? *
How did you hear about me?
Thank you! I look forward to talking to you soon. Feel free to add anything else below my signature.
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A copy of your responses will be emailed to the address you provided.
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