Thank-you for ordering your Individual Consultation. Your payment has been processed through PayPal.

Please complete your consultation request by completing the following steps:

Step One:

Please book your consultation on my calendar by clicking on the link below (or click the button):

Step Two:

Please take your time and complete the following questionnaire. This is thorough and will take some time for you to complete, but it is essential to our scheduled consultation session. We are unable to proceed with teh scheduled session without you having completed this.

Individual Consultation Questionnaire

PayPal Order ID (required - from your PayPal receipt):

Your Name (required)

Your Email (required)

Questions: (Note: All fields are required.)

  1. What is your highest sense of urgency in your life right now?
  2. What are you looking forward to right now?

  3. When you think about what you want, what is holding you back?

  4. What is your present occupation?
  5. If you had a USB port on your body and could “download”; what skills would you appreciate having immediately?
  6. What has been your proudest accomplishment in your life?
  7. Do you have a life Mission and if so, what is it?
  8. Please identify 3 of your greatest strengths.
  9. If you sabotage yourself, how do you do that?
  10. Please rate yourself as life “working well” (0-10) and 10 being highest, in the following categories.

    Personal and Professional Life  0 1 2 3 4 5 6 7 8 9 10
    Primary Relationship  0 1 2 3 4 5 6 7 8 9 10
    Education  0 1 2 3 4 5 6 7 8 9 10
    Recreation  0 1 2 3 4 5 6 7 8 9 10
    Health and Fitness  0 1 2 3 4 5 6 7 8 9 10
    Business and Career  0 1 2 3 4 5 6 7 8 9 10
    Friendships  0 1 2 3 4 5 6 7 8 9 10
    Business Network of People  0 1 2 3 4 5 6 7 8 9 10
    Money Management  0 1 2 3 4 5 6 7 8 9 10
    Family  0 1 2 3 4 5 6 7 8 9 10
    Personal Net Worth  0 1 2 3 4 5 6 7 8 9 10
    Passive Income  0 1 2 3 4 5 6 7 8 9 10
    Social Engagement (Community)  0 1 2 3 4 5 6 7 8 9 10
    Level of what you perceive as Fear  0 1 2 3 4 5 6 7 8 9 10
  11. What specific goal do you wish to accomplish in the next 6 months?
  12. Are you in debt right now beyond what you can invasion being responsible for?
  13. Is there anything that you are pretending NOT to know about your life ?
  14. Do you use Alcohol, nicotine or other drugs regularly?
  15. What is your understanding of where you get energy?
  16. Do you consider your life now having a solid foundation?
  17. Thinking of your whole life; what percentage is lived for others vs. yourself?
  18. Why do you believe now is the time to engage with a Professional Coach?
  19. What is your expectation of this engagement?
  20. How can we measure or identify that we have succeeded in that intent?

  21. What makes you sad?
  22. What makes you smile with joy?
  23. Do you desire more peace in your life?
  24. Do you hold hatred of anything; and if so what?
  25. Offer a list of 5 things you want more of in your life.
  26. Do you really know what you want?
    (Answering “no” is very acceptable as most people truly do not know)
  27. In your idea of self, what is holding you back from doing what you want to do?
  28. What will happen or be the consequence of you not doing something you want?

  29. What would be the real cost of not taking action on behalf of your needs now?
  30. Do you have supportive community around you when you reflect upon your life and goals?

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