Name* Email Address:* Phone Number:*Tell me where you're located (City/State/Country):*Tell me a little bit about yourself:*Why are you interested in a Life By Design session with The Cheerful Mind, Inc.?*What aspirations/goals do you currently have for your life?*What challenges are you experiencing that are preventing you from achieving those goals?*In what ways do you sabotage yourself with regards to what you want most? (In other words, how do you get in your way?)*What are your greatest fears?*What steps have you already taken toward achieving your goals? (i.e. support from a coach/counselor, read books, taken classes, etc.)*How interested are you in exploring coaching (either with me, or any coach) to accomplish your goals and live a more fulfilling life? Explain.*How committed are you on a scale of 1-10 to really stretch yourself, dig deep, debunk the fears and negative beliefs holding you back, and take powerful action to make real change for yourself?*1 | Not really2345 | Kinda ready678910 | I'M readyHow did you find out about The Cheerful Mind?* Would you like to receive the Cheerful Mind newsletter, where you can get happiness and productivity tips delivered straight to your inbox?Yes!No Thanks..I'm already signed up 🙂Do you have interest in learning more about the following products and services from The Cheerful Mind? Choose as many as you like* Private Coaching Accountability Success Circle Speaking Engagements + Workshops Planning VIP Day Annual Planning Retreat Body Language (Non-verbal communication) Training/Coaching/Consulting Is there anything else you would like me to know? (OPTIONAL)
