Coaching Application for Keyen Lage's Coaching Services
Thank you for taking the time to fill out the below questionnaire as honestly as possible, for saying "yes" to stepping up and taking action and for giving me the opportunity to join you on your journey.

I'm excited to connect further🚀
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Email *
Name *
Country you currently live *
What made you decide that you would like to work with a coach at this point in your life? (Did something happen recently that convinced you that you need to make a significant change?) *
Why would you specifically like to work with me? *
What are the three primary results you would like to see in your life or yourself through us working together? (Be brief, describe each result in one short sentence or phrase) *
Have you worked with a coach or other professionals in the past to help reach your goals? (examples: counselor, therapist, psychologist, mentor, business coach). If yes, what was your experience like? *
Which of the following ranges fits your monthly budget for coaching? *
This space is an opportunity for you to discuss any other topics that you feel were not covered in this questionnaire, that you would like to discuss further with me. *
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