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* 1. What is the #1 challenge you face when going after the things that you want?

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* 2. Please tell me how come you choose that response and share as much detail as possible:

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* 3. What is the main reason you are seeking coaching/counsel?

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* 4. Name:

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* 5. Occupation

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* 6. Approximate yearly income

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* 7. Would you like to receive my newsletter with self help tips, practices, and guides.

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* 8. Phone number:

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* 9. Email address

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* 10. Instagram/tiktok username

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