VIP Blueprint Builder

Imagine going on a special retreat designed just for you, with your own personal guide to ensure you return home with the fresh-start and the transformation you want most. The Blueprint Builder is designed to make sure your experience is both personalized and impactful.

I want to learn about you. What matters most in your life? Tell me about your dreams, the challenges you face, the things that stress you out, and what you love. Maybe your desires are crystal clear, maybe they're a little blurry, either way this assessment is a chance to hone in on what matters most to you and get the two of us on the same page. After all, we're about to embark on an adventure together.

*If you are a mother/daughter team it is important for each of you to build your own blueprint.


Sign in to Google to save your progress. Learn more
Email *
Who is filling this out? *
First Name *
Last Name *
Mobile Number *
Birthday. (not required but fun to know.)
MM
/
DD
/
YYYY
Place these 3 topics in the order of most important to least important. (Did you know these are the most searched topics on the internet?) *
1st priority
2nd priority
3rd priority
Health
Wealth
Relationships
Which areas would you like to work on most? *
Required
The most stressful thing in my day is... *
The thing in my day I look most forward to is... *
If I get an ounce of free time you will probably find me... *
  Which is your biggest obstacle towards reaching your goal?  
 *
Usually when I set my mind on something...
 *
When it comes to creating which ones best describes you? *
Required
  What activities do you enjoy getting lost in?  
 *
What actions and habits do you currently take to achieve your most important goals? *
What stage of change are you currently in? *
Do your desires align with your actions in your daily life?

(for example if you want to feel more energized do you get enough sleep, eat nourishing foods and exercise regularly?) 
 *
Why do you want to attend this retreat? What solution do you hope to find from this experience? *
If you could wave a magic wand over your future and you could feel any way that you wanted, be anything you wanted to be and have everything you ever wanted to have…what would your future look like? 

What do you want to HAVE?
What do you want to BE?
What do you want to FEEL?
What do you want to DO?  
 *
Which of the following attracted you? *
Required
Do you have any food dislikes, allergies or dietary concerns? *
Do you have any stories, fun facts or important information you would like me to know?
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms