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Services
Contact

Schedule an Appointment

Contact Us

First Name *

Last Name *

Date of birth *

Address *

Email *

Phone *

Tell me a little about yourself.

On a scale of 1 - 10, how content are you with your life currently?

1 - Extremely Dissatisfied
2- Very Dissatisfied
3 - Dissatisfied
4 - Somewhat Dissatisfied
5 - Neutral
6 - Somewhat Satisfied
7 - Satisfied
8 - Very Satisfied
9 - Highly Satisfied
10 - Extremely Satisfied
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What do you expect from your time working with a coach?

How would you like to feel at the end of our coaching sessions?

What would you like to achieve in your coaching sessions with me? Select one or more from the list below.

Manage stress

Improve my self-esteem

Gain a work/life balance

Become more confident

Learn to deal with feelings

Be more motivated

Understand what motivates me

Overcome tiredness and exhaustion

Identify goals and action steps

Become more productive

Learn about who I am

Get support and encouragement

Improve my communication

Other

If we were to start working together, is there anything else you'd like to share?

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Phone : +1 (716) 202-9130

Phone : +1 (716) 202-9130

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