1. Basic Information Full Name Phone Number Email City / Country 2. First Contact How did you find me? InstagramReferralBooksWebsiteOther Have you already had any contact with my work? YesNo (Yes) which one? 3. Where you are right now Right now, what feels out of place in your life or in the moment you are in? Where would you say you are at this moment? Looking for clarityIn a process of changeI know something has to change, but I have not taken the step yetMaking important decisionsReordering my life or my directionOther Please specify: 4. Previous experience Have you done any kind of personal work before — coaching, therapy, or a personal growth process? YesNo If yes, what kind of process was it? Did it help you, or did it leave you with more questions? 5. Readiness and investment This space asks for openness: the willingness to see your situation clearly and make decisions about it. Do you feel you are in that moment? YesNoI am not sure yet This 1:1 consulting is a personalized, direct working space, and it involves a financial investment. Do you feel ready to invest in this process at this moment? YesNoI would like more information before deciding If you checked “I would like more information before deciding,” tell me what would help you decide: The investment and payment optionsHow the process works (format, length, frequency)Whether this space is right for my momentOther Please specify If you decide to move forward, what is the first thing you would like to bring into order through this consulting? I authorize the use of my information so that I can be contacted about this application.
