Invest 10 minutes to provide us with information to help you define and achieve your goals
About You
Are you stuck in your career, relationship, home life or even your body?
Career
Home Life
Body
Do you ever feel lost and if yes what emotions do you feel?
Unhappy and need to find purpose
Depressed and feeling like there is no way out
Hopeless and need motivation
The world is a complicated place
Do you easily give up when facing a hard problem?
No
Yes and feel hopeless and negative
Yes but would try again when I get some support
Do you have a goal that you want to achieve but are struggling with it?
No but you do want to find a goal to focus on
Yes but goals keep on changing and not sure which one to stick with
Yes but don’t know where to start
Yes but loose focus and don’t see progress
Yes but finding it difficult to achieve it for whatever reason
Yes but can’t envision the way forward
Do you doubt yourself?
Sometimes
Never
All the time
Do you have trouble following through with things you start?
No
Sometimes
Only when there is a reason
Could your self-confidence do with a boost?
No I am the best version of myself
Only when I feel down
Only when certain challenges happen
Only when others are excelling and I am not
Are you ready to commit and change your life?
Yes
No
If I can see a clear goal
Is there anything else you would like to tell that may help us when coaching you to achieve your goals and fulfill your potential?
Personal Details
What is your age?
What is your occupation?
Name
First Name
Last Name
Email
example@example.com
Phone Number
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