* 1. Contact Information

* 2. What is your biggest challenge or frustration?

* 3. How would it feel to be free of that problem?

* 4. How have you tried to solve that problem?

* 5. What makes you feel successful?

* 6. What are 3 things that if you accomplished them this year would make you feel awesome?

* 7. What's holding you back from pursuing your dream lifestyle?

* 8. What do you enjoy least about your current work situation?

* 9. What would you try now if you knew you couldn't fail?

* 10. What is your age?

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