Unblock Your Bliss session application Question Title * 1. Hello beautiful! Let's dive right in, shall we? Tell me a little bit about yourself ... (Just a brief introduction including who you are, how you found me, and why you want an Unblock Your Bliss session is fine.) OK Question Title * 2. How do you feel about your life right now? My life sucks. I love every single moment of every single day. My life is perfect! My life sucks. I love every single moment of every single day. My life is perfect! OK Question Title * 3. How do you believe coaching will benefit you? (Choose as many as apply.) Improve health/wellness Create a lifestyle that reflects my needs, desires, and how I see myself Improve spiritual connection Create accountability Increase confidence Get clarity on what I want Learn how to set boundaries that are both effective and feel good Improve my relationship with money so I can get more of it Learn new and better self-care practices Cultivate compassion for self and others Improve relationships with self and others Get inspired to make positive changes Get support reclaiming my personal power Shifting my perspective from one of fear and scarcity to one of abundance and courage Get help with goal-setting and learning strategies for achieving them Finding my purpose Learning how to communicate more effectively and enjoyably Reframing my mindset Having some general support and encouragement during transformation Learning how to love life Getting help navigating a major life change Other (please specify) OK Question Title * 4. How much are you willing to invest in yourself? In your transformation? I'm still too afraid to take a big leap. ($0-$499) I know I need to change, but I also don't feel super confident in my ability to make it happen yet. ($500-$2999) I'm getting really warm.. I ready to make a change. ($3000-$7499) I am on fire! I am ready to take the plunge! I NEED to transform my life, to be happier, healthier, and clearer on what I want from life and how to live with purpose and ease. I am ready to live the life of my dreams. I am ready to level up to the next higher version of myself. Let's do this!! ($7500+) OK Question Title * 5. How fully do you believe the following statements: I am the creator of my own experience. I can choose bliss, or I can choose something less. It's up to me, and me alone. 0% (I don't believe this at all.) 50% 100% (I fully believe this without even the slightest shadow of a doubt.) Clear i We adjusted the number you entered based on the slider’s scale. OK Question Title * 6. What is right with your current experience? OK Question Title * 7. What would you like to change about your current experience? OK Question Title * 8. WHY do you want to make these changes? OK Question Title * 9. How committed are you to showing up EVERY DAY to do the work required for the transformation you're seeking? I'm not committed. I'm pretty committed, but I have other commitments that might take higher priority. I am in to win it! No excuses! I'm not committed. I'm pretty committed, but I have other commitments that might take higher priority. I am in to win it! No excuses! OK Question Title * 10. If we're feeling a good synergy, and decide to explore working together, what is the best way to reach you? Name Address Address 2 City/Town State/Province ZIP/Postal Code Country Email Address Phone Number OK DONE