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Sound x Selfcare
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BEFORE WE START OUR JOURNEY, PLEASE FILL OUT THE FORM BELOW
Client Intake Form
First Name
Email
Have you been coached before?
Yes
No
What age range do yo call into?
20-29
30-39
40-49
50-59
60+
Last Name
Phone
What best describes your current profession?
Entreprenuer
Corporate Professional
Freelancer
Healthcare
Other
01. What are your primary health and wellness goals? (eg, stress reduction, weight management, improved sleep, creating better habits, better nutrition)
02. What specific outcomes are you hoping to acheive through this program?
03. Do you have any existing medical conditions or health concerns?
04. What areas of personal development are you most intrested in? (eg. self-awareness, emotional intelligence, productivity, nutrition)
05. What expectations do you have for me as a coach?
06. On a scale of 1-10, how serious are you about making change in your life? (1 being not serious, 10 being extreamley serious)
7. What are you struggling with the most right now?
Stress
Burnout
Anxiety
Work-life balance
Emotional Exhaustion
Finding Purpose
Creating better habits
Working Out
Other
08. Are you financially ready to invest in your well-being?
09. What is yor budget for personal development and wellness services?
$0-$500
$500-$1000
$1000-$1500
$1500 - $2000
$2000 - $3000
$3000+
Can't put a price tag on health, wellness, and personal development
10. Is there anything else you would like to share before we hop on a call?
Schedule My Discovery Call
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