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Fill out this application and I'll get back to you in two shakes!
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Name
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First
Last
Email
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What's your biggest challenge when it comes to your life, health and well-being? What keeps you up at night?
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What aspects of your life are feeling most challenging to you right now? Where do you feel you need the most support?
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Loving/accepting my body
Losing weight
Emotional eating/binge eating
Living a life that makes an impact / knowing my purpose
Decreasing stress/anxiety
Making time for Self-care/Work-life balance
Loving my self/improving my sense self-worth
Having the confidence to express myself/stand up for myself
Career and achieving life goals
What are your top three goals that you want to work towards this year in your health and life?
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If you could wave your magic wand and have anything you want for your life and health, what would that be?
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On a scale of 1 to 5, how committed are you to transformation in the areas of your life selected above?
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1 - I can live with life as it is
2
3
4
5 - I'm beyond ready to transform my life and will do whatever it takes
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HOME
ABOUT
ABOUT YOU
WORK WITH ME
THE PERMISSION CIRCLE COMMUNITY AND GROUP COACHNG
MENTORSHIP FOR NEW COACHES
HAPPY CLIENTS
BLOG
Free Stuff n' Things