Congratulations on investing in yourself and giving me the opportunity to help you create an extraordinary life.

I believe that it is every woman's birthright to live a life of meaning, power, passion and purpose - and that's what I want for you.

Thank you for taking the time to fill out the below questionnaire as honestly as possible, for saying "yes" to stepping up and taking action and for giving me the opportunity to join you on your journey.

I can't wait to connect.

Name

First Name

Last Name

In order for me to get a "virtual fingerprint" of who you are, please fill out a description of your upbringing and how you view the world as detailed as possible, below.

State 3 specific outcomes that MUST happen in your life in the next 12 months. Pick goals or outcomes that will change your life in a HUGE way, and they don't have to be realistic. Think and dream BIG.

What's preventing you and what's the price you'd pay (energetically, emotionally, financially) to get to where you want to be?

Do you believe huge transformational shifts can occur in your life? (i.e. in your relationships, self-love, belief systems, income, etc.)

If age, finances or time wasn't an issue, what would you be doing with your life?

In your own words, what do you consider to be your obstruction (character flaw or biggest saboteur) to personal and professional growth? Please include any stories you keep telling yourself as to why you can't be successful.

What do you believe to be your biggest sources of guilt and shame?

Does something or someone in your life prevent you from doing what you feel called to do?

It's been my experience that it's not the size of that problem that matters. It's the size of the urgency or the commitment level that allows people to make positive and lasting change in their lives. One a scale of 1 - 10, how would you describe your level of urgency or your commitment to change your life?

Have you ever worked with a coach/mentor before? If so, what was your experience?

This space is an opportunity for you to discuss any other topics that you feel were not covered in this questionnaire, that you would like to discuss further with me.

Please provide your preferred method of contact (either Facetime or Skype) and the number or Skype address where I reach you.

Thank you for taking the time to invest in YOU today. I can't wait to connect and discuss the possibility of joining you on this new and life-changing journey.

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