What is your name?

What is your email address?

What is your phone number?

What is it you want to achieve?

Why is this important to you? What problem would it solve for you?

Have you tried any other programs or coaches to try and achieve the same goals in the past? If so, how did those go? (If no, just put 'no').

When are you looking at starting?

Yesterday

Within a week

Within a month or so

Longer than 3 months away

How did you hear about me and what made you decide to reach out?

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