* 1. What is the biggest challenge you are facing, the thing that keeps you up at night?

* 2. What is is that you want more of in your life?

* 3. What is standing in the way?

* 4. What are you *done* with?

* 5. What are you willing to do to create change?

* 6. What would it look like to completely realize the change I'm looking for?

* 7. What is your current 11th Step practice or relationship with a Higher Power?

* 8. What would you like that relationship with a Higher Power to look like?

* 9. How long have you been in recovery?

* 10. Please enter your name, cell phone and email so that we can contact you about the program:

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