Please fill this form in preparation for our call. (5 minutes)
I look forward to hearing more about who you are, your hopes, dreams and focus.
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Email *
First Name *
Last Name *
How would you describe yourself demographically & professionally? 
What's your relationship to time? *
Do you believe you are creative? *
Check off your top 3-5 from this list *
How much time, energy and attention are these problems costing you?
On a scale of 1-10, how motivated are you to fix these problems? *
Not open
Very open
What unrealized goal or project or body of work do you want to achieve in the next 10 years?
What's been holding you back? *
Do you have a 10 year plan? *
How closely are you following these plans of the future? *
Not closely at all
Very closely
A copy of your responses will be emailed to the address you provided.
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