Apply for Online Life Coaching

Your Information

First name

Last name

Phone

Address

Goals & Motivation

1. What brings you here today?

2. What specific goals do you want to achieve through this work?

3. Why is now the right time for you to invest in this work?

Current Challenges & Patterns

1. What patterns or challenges have you been struggling with repeatedly?

2. How do these challenges show up in your life?

3. How have you tried to address them in the past?

4. On a scale of 1–10, how ready are you to take responsibility and commit to change?

Mindset & Readiness

1. How do you typically respond when faced with discomfort or challenge?

2. What does “taking responsibility for your life” mean to you?

3. Are you willing to face uncomfortable truths about yourself in order to achieve your goals?

Yes

Commitment & Availability

1. How much time are you willing to commit weekly to this work? (Options: 1 hour, 2+ hours, etc.)

2. Are you open to a 3, 6, or 12-month structured program to achieve meaningful results?

Yes

3. How soon would you like to begin working together?

4. Are you financially able to invest in this work at this time?

Yes

Reflection

1. Is there anything else you’d like me to know before our first conversation?