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* 1. Provide the following information:

-Name (first and last name)

-Preferred gender pronouns (she/her/hers, he/him/his, and they/them/theirs)

-Email

-Phone number

-Time zone (Eastern, Mountain, and Pacific) 

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* 2. What is your occupation?

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* 3. What coaching services are you interested in? 

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* 4. Describe in detail the reason(s) you are seeking coaching support.

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* 5. How would you like your life, career, and/or business to feel and look like after you receive coaching support? 

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* 6. What is getting in the way of you accomplishing your goals (mindset, stress, emotions, people, time management, motivation, accountability, resources, procastination, etc.)?

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* 7. Have you worked with a coach before? If yes, describe the experience(s) in a several sentences. 

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* 8. Is there anything else you would like Ananda Leeke Consulting to know about your coaching needs?

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