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FREE Life Coaching
Please complete the questions below to receive your FREE 15-minute coaching session. Once submitted, you will receive an email from Dr. Cook with available times. To participate, all you'll need is a smart phone and a good cup of coffee.
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* Indicates required question
Email
*
Your email
What's your name?
*
Your answer
Where do you or did you work? (Company)
*
Your answer
What do you do? (Job/Occupation)
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Your answer
What do you wish you did?
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Your answer
How motivated were you at the start of 2020?
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Low
1
2
3
4
5
6
7
8
9
10
High
How motivated are you today?
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Low
1
2
3
4
5
6
7
8
9
10
High
I have to wear pants v. I don't have to wear pants (office v. virtual)
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100% office
100% remote
50/50 office/remote
75/25 - office/remote
75/25 - remote/office
Not employed due to COVID19
I'm a stay-at-home parent so all of the above!
Other:
If I could only have one goal, it would be
Work/Life Balance
Productivity
Better Habits
Career Path
Relationships
One goal? All of the above please!
Other:
Clear selection
My life currently...
*
Single
Married
Divorced
Widowed
Having fun
Don't even ask
Prefer not to say
My mind is frazzled because I have
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1 kiddo
2 kiddos
3 kiddos
I'm officially crazy and have 4+ kiddos
I'm trying!
Kids? Haha... No! I get to sleep in.
Other:
For the ones with kiddos, what are their ages?
Your answer
Do you have a goal for yourself this year? If so, what is it?
Your answer
What made you give this free session a try?
*
It's free
I need motivation
I need help
I would like an accountability partner
I need to figure out my life
I'd like to get to the next level.
I have no idea
I actually didn't. I mindlessly arrived here.
Other:
Best time to connect?
*
I can make it happen during the work day.
Lunch
Early riser
After 5pm
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