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Health Coaching w/Erica Questionnaire
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1.
Please provide me with your contact information.
(Required.)
Name
Country
Time Zone
Email Address
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2.
Please tell me a little bit about yourself and why you are interested in working with me.
(Required.)
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3.
Are you currently:
(Required.)
Trying to conceive
Pregnant
Nursing
None of the above
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4.
What 3-5 areas of your health/life are you currently struggling?
(Required.)
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5.
Have you previously worked with a coach?
(Required.)
Yes
No
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6.
What do you feel you need most right now?
(Required.)
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7.
What would you like your life to look like in the next 6-12 months?
(Required.)
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8.
Why is now the time to take action? What will your life look like if you don't take action?
(Required.)
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9.
On a scale of 1-10, how motivated are you to working with a coach? (1 being the least, 10 being fully-committed)
(Required.)
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10.
If we decide it's a great fit are you ready to financially invest in your health? Note that I do not do one-off sessions, only package options because that's how I'm able to help you get the best results! (we will go over details + options during our discovery call):
(Required.)
YES! I'm absolutely committed to financially investing in my health + future!
There's no way I can invest in my health + future at this time
Not sure...
11.
Please provide any additional information or questions you would like to share/ask before submitting your application. Then schedule your 20-minute discovery call with me so I can explain more about what working with me entails, the investment, and answer your questions about working with me:
https://calendly.com/erica_ziel/20min
