ReBirth Consult Application
To be completed after a time is secured and returned a minimal of 24 hours before scheduled session.
NOTE: If completing on a Mobile device, take extra care to insure form is complete & sent.
ReBirth & Emerge Transformed!
FULL Name *
Your answer
Email *
Your answer
Mobile *
Your answer
What 3 areas of your life would you like support? *
This supports focus. Please choose a minimal of 3.
Required
Scheduled Time: Please NOTE for your tracking. *
Please call: 240-25-POWER or Skype: ReBirthbyLaToniaTaylor
Time
:
If money were NOT an issue what would you like to be your life's legacy? *
Your answer
What, if any, challenges are you experiencing currently? *
Coaching does not require a crisis or a challenge. It can be a NEXT LEVEL DESIRE. If so, please state those desires.
Your answer
Have you ever made a personal investment in yourself with coaching services or workshops? *
Required
What would it cost you if you do NOT invest now? *
Re: Sacred Love, Sex or Money Desires, Vision or Personal Development Clarity, Planning & Vision Manifesting.
Your answer
How well do you think you receive feedback? *
Feedback is neutral and usually based on trained observations in art of coaching & the science of spiritual law.
Your answer
If we decided to work together, what would be the happy ending you desire to see for the area that you listed as the challenge? *
Give me the unedited & unrestrained version!
Your answer
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