Clarity Form : Leadership/Consulting Programs Application
I deeply respect you and your time. If you invest the next 5 minutes into filling this out, I can begin to put together a framework that will give you back some time and reduce the energetic load of personal, professional or business growth. At the end there is a link to book our connection call so I can hear some more about your wants and show you what I have come up with. 

Please help me understand your current resources, who you understand yourself to be in your market right now and your current boundaries on how you want your next season of life to look and feel like. 



NOTE: Please Write N/A if you do not wish to answer a question at this time or feel it does not pertain to your goals at this time. 


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Email *
What is the best number to contact you for follow up? *
How did  you connect with me? ( Be specific if you can)  *

What made you reach out and want to book the call?


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What industry are you in?  What is your current role and type of career or business?  *

Are you stuck or moving in another direction?

— How long have you been trying to fix this?

— What is frustrating you most about this issue?   


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What industry do you want to be in 90-120 days from now?   *
Thinking holistically, what top three things are you interested in doing this next year that have eluded you before? Have you been coached or trained on each goal specifically yet?  Be specific.  *
What do you see as the challenges you face thus far in achieving these goals? Feel free to write "I don't know" *
Your answer

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If you have not already included them, do you have any relational or health challenges you face thus far that take some energy and time from you?   Feel free to write "I don't know" *
Your answer

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How do you define success now and how has it changed over the past 5 year(s)?   *
List 3 things you love about your current life? *
What did/do you love about your current position/career? *
What do you hate about your lifestyle , workstyle or both right now? If nothing write n/a. *
Are there any gifts and talents or activities of daily living you wish you had more time or energy to develop? If so, what are they?  *
 Do you have any experience in coaching, teaching, writing, therapy, consulting or public speaking?  *
Why make a big leap into ending your struggle now? What draws you to improve your hustle in life or participate in a better success path enough to take action right now? 
One of the first things I will do if we work together is get an objective profile of your best communication style and core drivers.  How do you see yourself?  1) Promoter/Visionary 2)Analytical and Analyzer  3) Big Supporter-Helper  4) Controller/Lead Authority.  Feel free to pick up to two ways of being if you feel between . 
What is the most common feedback you get from past  mentors, teachers ?
What is the most common feedback you get in terms of your leadership ability ?
What is the most common feedback you get from friends and family in relationships?
What do you think one or two of your top core motivators are behind what you get accomplished in life? 
What is the most common feedback or struggle you find when you are trying to present something new or make a move into a more bold contribution in your current circles?
I bridge the science, art and spirit into being the CEO of your life. Are you a spiritual person?
Is one of your top 3 priorities more intimate growth and evolution as a person? 
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Required
Do you feel unclear, unheard or unsafe in any areas of your life ( physical, emotional, mental, social, financial, spiritual, sense of purpose)? If yes, which areas ?
Looking back, Were you ever being abused or abusive to yourself or others in how you have executed your life thus far? If yes, I invite you to express in what ways if you are comfortable. 

No judgement. These tendencies are just often tied to triggers and energy leaks. You are here to curve into a better response to stress and focus that energy you generate into your now life so feel free to show me the weeds you know. 
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How do you prefer to learn? *
Required
What level investment are you ready to put into this next leap ? *
Is there anyone else you need to consult with before investing in yourself and this deep support if you are ready to begin?   *
Are you in need of having this financed over the next year?
Clear selection
Any other thoughts around this conversation or questions you would like to share?
Can I add you to my general email list for access to a variety of tools and save you some time getting updated health, growth and development resources? 
Next step:  Thank you so much!  . Please book your consult within the next 30 days HERE .    I will review this over the next business day
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