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* 1. Please complete your personal details below

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* 2. What drew you to this program?

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* 3. What is your biggest obstacle right now?

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* 4. Why do you want to achieve at the end of this program?

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* 5. The fee for this 12 week program is $3000 - are you willing to pay this amount after our conversation if we are a good fit for working together?

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* 6. This program requires you to show up once a week for 12 weeks, with homework from each session that needs to be completed before the following session - are you ready to commit to that level of work?

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* 7. What, if anything, would prevent you from following through on the homework and showing up each week?

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* 8. This program is designed to help you stand in your power - what does this look like for you? How will you know you are standing in your power?

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* 9. Have you ever tried a program like this before?

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