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