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Transformation Program Application

I would love to learn more about you and your practice as well as about what transformation you desire. Please complete the application and schedule a complementary strategy session call.

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Question 1 of 28

First Name

Question 2 of 28

Last Name

Question 3 of 28

Email Address

Question 4 of 28

Phone Number

Question 5 of 28

Give a verifiable link where you are on social media or your website.

Question 6 of 28

Which statement is true for you?

A

I am thinking about launching a practice.

B

I have already started my entrepreneurial journey.

C

I have an established practice and I want it to grow and be sustainable.

Question 7 of 28

What life-changing work do you do or want to do?

Question 8 of 28

What is your specialty or niche?

Question 9 of 28

What areas of your life do you want to transform? 

(Select all that apply)
A

I would like to be brave for myself in launching or growing practice.

B

I want to be authentic in my personal and professional growth.

C

I want to show up for myself in a way that is compassionate and balanced.

Question 10 of 28

How satisfied are you with the balance you have in your life?

A

Not at all

B

A little bit

C

Somewhat

D

Mostly

E

Very Much

Question 11 of 28

What is your biggest concern in running a profitable practice?

(Select all that apply)
A

Practice Start Up - forms, website, billing, legalities

B

Building Your Team - Therapist Recruitment, Administrative, Accounting, Attorney, Advisors

C

Marketing, Networking, Refferal Sources

D

Building Business Mindset - Leadership, Insurance Contract Negotiation Fees, Risk Management, Independent Contractor Fee Splits, Paying Yourself as Owner

E

Work- Life Balance - Burnout, Self-care, Have Balance with Family, Friends, Work, Education, Spirituality, Growth, Guidelines for Vacations

Question 12 of 28

What other ways can you benefit from support?

Question 13 of 28

Is now the right time?

Question 14 of 28

What is your big vision?

Question 15 of 28

How do you connect your wounds to success?

Question 16 of 28

Who do you turn to when it is time to celebrate?

Question 17 of 28

Do you have a gorup of people that help you elevate your sense of self?

A

Personally?

B

Professionally?

C

No I don't. I tend to be the one who elevates others?

Question 18 of 28

Are you in a place in your life where you are ready to say yes to you? If yes, how soon do you want to get started?

Question 19 of 28

Do you have any fears about starting a new chapter of your life? If so, what?

Question 20 of 28

What do you earn?

Question 21 of 28

What is your annual revenue goal?

Question 22 of 28

How will reaching your annual revenue goal change your life?

Question 23 of 28

What type of coaching and consulting support are you looking to invest in and for your BUSINESS growth?

Question 24 of 28

What type of investments have you made in your PERSONAL development? What has been the direct result of investment? List all below.

Question 25 of 28

How much would you be willing to invest to meet your life and business goals? If you are not investment minded, this session is not for you.

A

$3000 - $5000

B

$5001 - $8000

C

$8001 - $12000

D

$12001 +

Question 26 of 28

Why are you looking to invest in coaching and consulting with me? Be specific.

Question 27 of 28

How soon can you get started?

Question 28 of 28

What else do I need to know about you? Are you an action-taker, implementer, go-getter, high-integrity person who loves being in community with other successful, achieving private practice owners? (Answer both questions)

Confirm and Submit