What is your first name?
What is a good email for you? 📨
*
What is your cell phone number? 📱
*
What is your current profession?
What is your current monthly revenue?
Under $1000 per month
$1,000-5,000 per month
$5,000-10,000 per month
$10,000-20,000 per month
$20,000 plus per month
What is your relationship status?
Single
In A Committed Relationship
Married
Separated
Divorced
Unhappily married
Tell me: Why are we here? What isn't working?
What would be the greatest success in working together that you can currently see?
How willing and able are you to own where you are and confront everything that is keeping you there so that you can move FORWARD into a NEW CHAPTER?
Nothing changes if nothing changes. I am 100% in and open.
I am open and ready, but I don't know you yet.
What would you like to tell me about you and your situation that wasn't covered above?
If you're accepted, how soon can you get started?
Today
This week
This month
Next 3 months
This year
Not sure