Initial Enquiry Form

Thank you for your initial enquiry, please can I learn some further information about your situation.

First Name

Last Name

Email Address

What is your current role and how long have you been doing it?

{name}

What is your current situation and what do you want to achieve (please include what you have tried, what hasn't worked and any other relevant information)?

{name}

How committed are you to making the changes on a scale of 1 to 10 (1 being not committed and 10 being you badly want this and are extremely committed)?

What will it mean to you if you get the results you want and what difference will it make to your life?

{name}

If you find that we are a good match and want me to be your coach, what if anything is likely to stop you going ahead with coaching (put n/a if this does not apply)?

{name}

What can you do to overcome this (put n/a if this doesn't apply)?

Where did you hear about me?

LinkedIn
Google
Referral
Networking
Speaking event
Other

Budget

If you go ahead with coaching, who will pay for it? You or your employer?

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