I don’t know what I need yet, but I want to work with you.

Thank you for being inspired and motivated in your decision. I appreciate your trust and will give my best effort to assist and guide you. Please take sufficient time to answer the following questions in full. Your answers will only be viewed by me.

Name

First Name

Last Name

Email Address

The day you joined the world?

YYYY

Call you, maybe?

Country

(###)

###

####

What city are you from?

What's going on?

Be real, open and honest. The more you can share, the more I can help.

What caught your eye or inspired you to connect with me?

Social media, website, word of mouth from a friend – tell me who! etc.

What is your ultimate goal in working together?

If I could wave a magic wand and grant you 3 wishes, what would they be?

Think back to a time in your life when things were going really well for you. Tell me about it!

Describe what filled your time, who was around, what activities did you enjoy, where were you etc.

What have you already tried that has worked successfully?

What sort of strategies are you a fan of?

What areas of your life do you have the most energy and enthusiasm for?

What area of your life do you find most challenging?

Please select all that apply.

Purpose

Passion

Health

Wealth

Happiness

Relationships

Family

Community

Who and what challenges you most in life?

Please share a time in your life when you felt supported. Who was supporting you?

What were the circumstances? What did they do? How did you feel?

Are you waiting for someone or something to happen?

Tell me why you think you haven't already achieved success in your life in these desired areas.

What are you NOT willing to do to achieve your goals?

Be honest. I need to know in order to help you.

What does the best and highest version of yourself look like - for YOU?

Not to your parents, your significant other, your sibling etc.

Are you ready to take 100% complete responsibility for your life?

This means no more blaming, excuses or reasons for your goals to remain unreached.

Are you willing to do whatever it takes, especially when it is NOT convenient or comfortable?

Be honest with me and yourself. This includes: exploring trauma, emotions and belief systems and really digging deep.

What is the best time of day for you to be reached?

Do you work 9–5 PM or is your schedule flexible? Do you have any standard commitments?

Are you suuuuure you're done?

I know this form isn't a walk in the park, but I seriously have so much gratitude for you taking the time to pour your heart into it. Can't wait to go through everything once you're complete!