Potential Client Questionnaire
I am Sarita and I am an Empowerment coach who specializes in mindset and healing and my mission is to redefine self-care for BIPOC women so they can go from feeling overwhelmed from the chaos of life to deeply connected with self. When we are filling up our cup, we thrive and when we thrive we are powerful. In order for me to have an idea about you, your desires, dreams and how I can support you, please answer the following questions as detailed as possible.
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What is your name *
What is your email address? *
What is your age?
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What are you currently up to in the world?
Please share the three specific areas or goals you are looking for support with in your life, relationships and biz/purpose. *
How would having a coach best support you with the above areas? *
On a scale from 1-10: How committed are you to having an incredible life and doing the work to get there? *
On a scale from 1-10: Are you coachable and willing to do whatever it takes? *
Have you worked with a Coach before or taken any self-development course? if so, who or what courses?
What is your income per month? *
Are you willing to invest in yourself in order to create a lifetime of results and to live your best life possible?! *
What has you feeling that Sarita is the right coach for you? *
Thank you so much for filling out this form. I will be in touch with you soon!
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