Feel better now. This is your time.  You're ready. 
Please allow a few minutes to read, contemplate, and honestly answer the following questions.  Not all area required so answer as you feel best suited.  Notice where you may feel 'stuck' - these are ultimately where the magic is deeply cut off!  [and will be addressed in our next steps].  All answers are confidential.  Congrats on choosing YOU.
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Email *
Name you prefer to be called: *
Today/recently, how are you?  How's life?  Why this now?  Go with the first, gut instinct answers that you feel like sharing *
If different from above, how do you sense I can help you specifically right now? [ex. have you heard me say something specific / know someone who's worked with me / etc.]
What's challenging you right now {unless you just included this above}?
What do you feel is next for you, whether it's a change you'd like to make, a leap you'd like to take, or anything in between?  Sometimes you may have a hint of what's to come...
What do you WANT next for you? {It's ok if you're not clear yet 😌}
Were there any sticky or stuck points you felt in your BODY or MIND in filling in these answers?  Please share where and what it felt like!
Have you done any other coaching, therapies, or personal growth work, either one-on-one or group setting?
If yes, please explain.
Thank you! If there's anything else you feel called to share, please do!  You'll get an email soon with some suggestions and/or potential next steps.
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