Email:

Full Name:

Phone Number:

When it comes to your happiness and contentment, what are your biggest challenges?
RelationshipsHealthFinancesOrganizationFaithOther

What have you tried already?
BooksBible StudyCounseling/TherapyCoachingDigital ProgramsMedicationOther

On a scale of 1 - 10 how important is it to you to have these challenges solved? (10 being the most important)
12345678910

Describe your vision of how you'd like things to look a year from now:

Please indicate how financially ready you are to invest in this journey
$0 - $100 (I have no money, I'm hoping you can direct me to some free resources.)$100 - $1000 (I'm hoping you can direct me to something cheap.)$1k - $10k (I'm done kidding around and I'm ready to invest in permanent life change.)Other

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