Name
*
First Name
Last Name
Email
*
Phone
(###)
###
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Current Business Situation
What stage is your business currently in? (select one)
What are your primary challenges as a business owner (select all that apply)
How do you currently feel about your business's progress?
Do you currently have a business plan or strategy in place?
Visions and Goals
What is your long-term vision for your business?
What are your top 3 short-term goals for your business?
Which of the following areas are most important to you right now? (select up to 3)
Mindset and Self-Awareness
What is your current mindset about your business? (Select One)
Do you believe limiting beliefs are affecting your business success? (select one)
10. How do you typically handle challenges or setbacks in your business? (Select one)
What personal or professional habits would you like to improve?
Energy Alignment and Support
Have you ever utilized energy healing or mindfulness practices to support your business success?
Do you feel aligned with your business purpose?
What emotions or sensations come up when you think about scaling or growing your business?
Commitment and Expectations
On a scale of 1–10, how committed are you to improving and growing your business? (Select a number where 1 = Not at all committed and 10 = Fully committed)
What support or tools do you think you need most to succeed? (Select all that apply)
What does success look like for you in this coaching process?
Additional Information
Is there anything else you would like to share about yourself and your business?
