Consulting Intake Questionnaire

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This form will allow me to make sure that I can provide the most value possible for our discovery call together. Please fill it out as thoroughly and honestly as possible, so that I can make sure that we are a good fit to work together.

Email *

Name *

Phone *

Location (City, State) *

What is the specific problem or problems that you are currently facing? *

As a result of the problem, what challenges or conditions are currently showing up in your life? *

How long has this been a problem? *

What have you tried to solve this problem? *

How important and urgent is solving this problem? *

What are your long term goals that you would like to work on through coaching? *

Are the important people in your life (spouse, business partners, etc) aware of you seeking coaching, and are they supportive? *

How willing and able are you to invest $1-$3K per month to sincerely up level your life? *

I have the financial resources to be able to invest right now.

I have access to financial resources to be able to invest right now.

I do not have the financial resources available to invest right now.

What attracted you to want to work with me? *

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