Name, first and last (please :D) *

Skype OR Zoom Name (if you have one)

Phone Number

Where do you live?

What time zone are you in?

What are the things you are juggling currently? Check all that apply.

Tell me about who you care for in your family. Check all that apply.

Have you had any big stressors happen in your life in the last year?

Brief idea of what you might want to talk about

If you could wave a magic wand and create your dream life, what would your life? (Don't hold back here. The bigger the better!) *

Can you identify anything you are struggling with in your life/work right now?

What are 2-3 goals you would like to reach in the next 6-12 months?

How many hours per week do you have available to work on impacting your life's dreams/happiness? So one way to measure this is how much time per week to you devote to self-care and nourishment (Be totally honest here, if the answer is not even 1 hour, that's ok)

Do you consider yourself an intuitive person

Are you looking for a coach at this time?

Are you interested in exploring working with Rachel at this time?

Anything else you'd like to add?