Clarity Session Application
All responses are completely confidential. When you are selected for clarity session, you will receive an email, detailing what to expect, and confirming a time and date for your appointment.
Name, First and last
I am interested in working with Jacqui through:
Private pilates/ yoga
Group fitness classes at Pure Body Bliss
Health and Lifestyle coaching
All of the above
The three biggest changes I'm looking for in my life are: (examples, weight loss, physical strength, stress reduction, resilience, etc.)
What are you aware of that keeps you from achieving the changes you want to see?
What is most at risk if things don't change?
What are 3 words that describe your current state?
On a scale of 1-10, (10 being completely committed) how committed are you to making the changes necessary to get what you want.
What times work best for you for a 20-40 minute call
Evenings after 5 pm
A copy of your responses will be emailed to the address you provided.
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