Discover Session Application

Working Together Application

By filling out this questionnaire, I'll learn a little bit more about you, and we'll make full use of our time on the phone. It helps us get straight to your core issues and desires. Please be as honest as you can.

* Indicates required field

Name *

First

Last

Email *

If you are in a country other than the US, do you have access to Skype? *

Yes No I prefer to use my phone

What is your line of work or primary endeavor? *

How long have you been doing what you're doing now? *

Describe the area of your life that is causing you the most concern right now. *

How is this affecting you? *

Have you tried other methods for resolving this, and if so, what? *

What were your results and/or issues with that method? Why did you stop? *

What will your life look like once this issue is resolved? *

Are you accustomed to investing in yourself for education, programs or personal development? *

Yes No This would be my first

Are you coachable, have you used coaches, and is 'doing the work' something you're comfortable with? *

Are you currently taking or have you ever been on the consistent use of pharmaceuticals designed to alter mood or behavior? *

Would you be interested in discussing the possibility of a one-day intensive? *

Are you the primary decision maker regarding spending for yourself in your household? *

Yes No It's complicated

Is there anything else you'd like to share with me before booking your appointment? *

Submit

Thank you!
The confirmation link should take you to my booking calendar for a Discovery Session.
If that doens't happen, please email [email protected].
Mahalo ~