Elevating Alpha 1-on-1 Coaching Application

Email address *

Tell me your name *

Why are you interested in coaching? *

What do you hope to accomplish with coaching? *

Do you believe you will achieve your desired result? *
YesNo

Are you willing to try all the exercises and homework? (Especially the ones you have resistance to?) *
YesNo

What is your biggest fear in life? *

Write down five major positive events in your life. *

Write down five major negative events in your life. *

What is the thing you most want to change in you life? *

What ARE you willing to sacrifice to change your life? *

What AREN'T you willing to sacrifice to change your life? *

Would anyone in your life be upset if you changed? *

What do you do for a living (what is your profession)? *

What is your net annual income? *
Less than $20,000$20,001 - $50,000$50,001 - $80,000$80,001 - $100,000$100,001 - $150,000Over $150,000

On a scale from 1-10 (10 being the most important), how important is it for you to make changes in your life? *
12345678910

Are you willing to spend between $5,000 and $10,000 on coaching to make these changes in your life? *
YesNo

What will happen if you don't change? What will it cost you? *

What is the most upsetting issue pressing on you now? What are your biggest personal and professional challenges? *

What is it worth to you to solve these issue forever? What is it worth to end all suffering? What is it worth to be able to choose happiness, confidence, and love at any moment? *

Are you ready to make a financial and time commitment to solving these challenges? *
YesNo

What do you think has prevented you from overcoming them so far? *
Your answer

What do you fear about this situation? *

How do you currently manage stress? *

What three emotion do you feel most often (ex. happy, sad, angry, afraid, anxious, love, calm, bored, worried, frustrated, confused, etc.)? *
Your answer

How much joy do you currently create in your life? *

What gives your life meaning? *

Do you believe you are living the life you were meant to live? *
YesNo

What do you want other people to know about you? *

Why do you I am the right person to help you make these changes? *
Your answer