Glow Up Discovery Call

First Name

E-mail

Do you currently have a business or consider yourself an entrepreneur?

Yes

No

If you are an entrepreneur, how long have you been in business? Skip if you are not an entrepreneur.

0-3 years

4-6 years

7-9 years

10+ years

Have you ever worked with a life coach before?

Yes

No

Preferred coaching/learning style:

1:1 Private Coaching (phone calls included)

Self-paced (group coaching call included)

Length of coaching:

I really just need help with overcoming one obstacle and need guidance but I can apply it on my own

I'm interested in doing inner work, applying what I've learned, and working on a long-term basis for continued support and accountability

Timeframe to hire someone to help you break free and start working towards your goal:

Just looking with no definite date

Now

1-3 months

4-6 months

When something goes wrong, who do you naturally blame?

Self

Other person

God/Universe

Nobody

When something is hard, I:

Give up

Ask for help

Look for solutions

Take a break and try again later

Burn myself out until I figure it out

What area of your life begs for improvement right now?

Business/Career

Money/Finances

Friends and Family

Self (Mind/Body/Spirit)

Goal you'd like to accomplish in 30 days:

How would you feel if you didn’t meet goal?

It wasn't meant to be

Better luck next time

Will find a way

Devastated

For personalized 1:1 coaching services, how much can you comfortably invest per month?

Up to $50

Up to $100

Up to $250

Up to $500

Up to $750

Up to $1,000

There is no limit

Have you been diagnosed with anxiety, clinical depression, ADHD or any other condition?

Yes

No

If you responded “yes” to the previous question, how are you managing? If you answered “no”, please skip this question.

No longer struggle with it

Holistic health

Medication

Trying to manage the best way I can but it's a struggle

Are you currently seeing a counselor, therapist, psychologist or other mental health professional?

Yes

No

As a life coach, do you understand that I cannot diagnose, treat or provide medical advice?

Yes

No

Of course, we want to make sure the relationship is mutually beneficial. Please complete the following intake form and if we believe it's a good match, we'll follow up with a link to hop on the calendar: