LEVEL-UP COACHING NEW CLIENT SURVEY Pre-Application Survey Question Title * 1. Are you ready to make a lasting change in your life and commit to your personal growth? Yes, I’m ready to start now! I’m interested but not quite ready to commit I’m just exploring my options Other (please specify) Question Title * 2. What is your primary goal for working with a wellness and mindset coach? Improve physical fitness and health Develop a stronger, more positive mindset Achieve personal and professional growth Enhance emotional and spiritual well-being Other (please specify) Question Title * 3. Email Question Title * 4. Name Question Title * 5. Mobile Question Title * 6. On a scale of 1 to 10, how committed are you to investing time and energy into transforming your mindset and lifestyle? I’m all in Very Somewhat Unsure Question Title * 7. Are you prepared to make a financial investment in yourself to achieve your goals? Yes, I’m ready to invest in myself! I need more information about costs and options. I’m not financially ready at this time. Question Title * 8. How soon are you looking to get started with your wellness and mindset transformation? Immediately! Within a month 3-6 months Unsure Question Title * 9. What challenges have been holding you back from reaching your goals? Lack of time or energy Financial constraints Unclear direction and lack of accountability Self doubt or mindset obstacles Injury Question Title * 10. Are you ready to step outside of your comfort zone and take actionable steps toward leveling up in life? Absolutely, let’s go Pretty sure, but I need some guidance Uncertain, I would like more information and clarity Done