Next Chapter Coaching
Full Name
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Email
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Phone
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Are you interested in group coaching or 1 on 1 coaching?
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What area of life are you looking to improve upon?
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Mindset & Motivation
Confidence & Self Empowerment
Fulfillment & Meaningful Purpose
Self-Awareness & Consciousness
Break Self- Destructive Habits & Limiting Beliefs
Health & Fitness
Check all that apply.
Tell me more about your goals & what you hope to achieve by working together?
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How long have you been trying to make these changes & reach these goals?
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What are some of the biggest challenges you face in reaching these goals?
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Tell me how you would feel & how your life would be different if you accomplish these goals!
Does your spouse or significant other support you? meaning they will give you the thumbs up with whatever you decide? (if single, say yes)
Yes, I have read this and can confirm
No, I am not sure if he/she does support me
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