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Client Application

This is an application to potentially work with me as your coach.
Thank you for taking the time to fill out this application. I only work with a maximum of 6 clients at a time and this application helps me identify if we would be a good fit.
If you are not interested in becoming a client please do not complete the application.

What is your Name?

What is your Email?

What timezone do you live in?

What is your ultimate goal or dream outcome?

What are your biggest challenges in your personal or professional life?

What have you tried so far to solve those problems that maybe hasn't worked out as well as you'd hoped?

What solutions do you wish existed to help you solve your problems & reach your goals?

Have you defined your Core Values? If so what are they?

Do you have clarity about what you want and what you don't want? Do you know how to get there?

Do you regularly practice self reflection? (Mindfullness, Journaling, Etc.)

Do you regularly practice self reflection? (Mindfullness, Journaling, Etc.)

If you worked with a coach what would be most valuable for you?

Are you willing to invest in coaching?

Are you willing to invest in coaching?
A
B
C
D

Which program are you interested in?

Which program are you interested in?
A
B
C

What is your level of commitment to change?

What is your level of commitment to change?
NoneAll In

Please provide any other details that would be relevant for me to know?

I'm not ready to change, return to the website, or need more information schedule a get to know you call.