Ready to be happy? It is possible for you to be happy both in business AND in love. It really is!
I commend you for your willingness to take a closer look at your relationships, both personally and professionally, and acknowledge what you are really feeling.  

Please take a few minutes to answer the questions below to see if we can partner to create a long-term transformation.  I will follow up in a couple of days to schedule a video consultation or recommend an alternative resource.
Sign in to Google to save your progress. Learn more
Email *
Name: *
Age: *
Relationship Status *
Email (Please check spelling) *
Best Phone *
State, City, Country
How Did You Find Me?: *
1) Rate each of the following Attraction/Relationship areas, from 1- 5 *1 is hardly ever. 5 is you can't imagine this could possibly be any better. I'm not judging you, so please be honest. It's the only way to get where you want to be. *
I feel great and confident about myself
I feel loved and appreciated in my relationships
I know what I want in a significant other and feel that I deserve it
I am able to ask for what I want/need with men, sexually and otherwise
I am clear on what I really want in a long-term relationship
I believe that there are good men out there and that I deserve to be in a relationship with one
I have a clear understanding of all blocks to my happiness both personally and professionally
My relationships with other women are great and I have a support system that I trust
I feel respected and valued throughout the day
My income is where I want it to be at this stage in my life
I am able to make a difference in the work that I do
I have the quality of life and love the I want
I feel like I have balance and control of my emotions on a daily basis
It is important to me to have a great support system
I have unresolved pain from my past that may be getting in the way of my happiness
I know what I want and I know how to articulate it
I feel empowered to bring my best self to the office everyday
I can assert myself at the office without getting too emotional
I feel like everyone is out to get me
I am questioning my place in my home/work life at the moment
2) Which of the areas above do you most want change in over the next 6-12 months? *
3) Describe what your connections and relationships would be like if nothing were limiting you or holding you back... *
4. What three things are you most tolerating or putting up with in your life? *
Which of these are you ready to handle? *
5) Assuming all human beings have some way of holding back or sabotaging our lives, which are your favorite methods? *
6) What would you get from coaching that would be most valuable to you? (Choose up to 3)
7) How coachable (open to input and feedback and ready to make changes) do you suspect you are? *
8) Primary Interest: *
What else do you want me to know?
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy