Date of Birth
* Date of Birth
What are your main health/life concerns?
Do you work with any other doctors, healers, therapists or coaches? If so, please explain.
Do you believe you are capable and deserving of living a healthier, happier, more beautiful life?
How dedicated are you to creating the changes and shifts you need to make in order to live the life you want?
I’m 100% ready and I’m totally willing to do whatever it takes to get me there.
I want to live healthier and create a beautiful life, but I struggle and feel like I just can’t get over the hurdle.
Change scares the hell out of me. I’m not sure I’m even capable of change.
If we decide you’re a good fit for my coaching program, and my coaching program is a good fit for you, how able or willing are you to invest in your personal development right now?
I have the necessary financial resources to invest in creating a healthier, happier, more fulfilling life.
I’ll do whatever I need to do to get the necessary financial resources to invest in myself and this process.
I have no financial resources to do anything different than what I’m already doing. I'm not open to finding any.
What hesitations (if any) do you have about working with a coach?
What excites you about working with a coach?
Why do you want to specifically work with me?
How did you hear about my program?
Thank you so much for taking the time to submit your enrollment form. Your answers will help me understand a bit about you in preparation for our chat.
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