ARE YOU READY?

Thank you for your interest in exploring a supportive relationship with me. Please answer the following questions to determine if we are the right fit for working together.

Name

First Name

Last Name

Email Address

What area of your life is creating the most challenge at the moment?

Relationships

Health

Work

Mindset

All

What specifically is going on for your right now?

For example: divorce, addictions, anger, stress, anxiety, career change

On a scale of 1-10 how willing are you to solve these challenges?

1 being the lowest and 10 being the highest

Are you able to dedicate time every week to solve these challenges?

Yes

No

What is the best possible outcome you would like to see in the near future?