Intake Form for Coaching with Matt
Please take a few mins to answer the following questions. No right or wrong answers. Give as little or as much detail as you feel is right for you. We will explore more in our consult call. 
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Email *
First Name *
Last Name *
Cell Phone *
1. For a moment, allow yourself to just naturally relax. As you feel yourself relaxing go back to the moment you decided to reach out.

What best describes your impulse to connect? (You can describe more later) 
2. Now, in a few sentences, describe what's been happening that has you now looking for assistance. We can explore more in our consult call. 
3. How long has this been on your mind or in your heart and soul? On a scale of 1 - 10, how big of an issue has this been for you? (1 would be 'it's not very important', 10 would be, 'it's painful.... I can't stand it anymore') *
4. What else did you try to overcome your challenges before reaching out? What happened, what was helpful? If anything, how did it help?
5. What has been the biggest challenge or obstacle in you moving forward, achieving this specific transformation, growth, or fulfillment in your life? What if anything makes it worse?
6. On a scale of 1 - 10 (1 being NOT READY, 10 being READY THIS MOMENT!) how WILLING would you to permanently resolve this TODAY? Without needing to know how, just how WILLING would you be? There is no right or wrong answer.
7. Why didn't you pick a lower number?
8. Imagine for a moment, we have completed a transformative process. What do you need to have, feel, do or experience to let you know our time is complete?
9. Have you invested in self-development or personal growth? If so, please list anything you've pursued here. Ex: books, online courses, youtube vids, coaches, counsellors, therapists, meditation, yoga, even skill or work related - whatever comes to mind.
Have you booked your consult:
A copy of your responses will be emailed to the address you provided.
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