Language
English (US)
Kickass Teacher Consultation
Thank you for your interest in working together. All client information is confidential and treated appropriately. I will notify you if your application is approved as soon as possible.
Only fields with an asterisk * are required. All others are helpful but not absolutely necessary.
Name
*
First Name
Last Name
E-mail
*
Do you want to receive inspiration, updates, and gifts via email?
Yes, Keep me in the loop!
No thanks, I’m good!
Best Contact Number:
*
Preferred method of contact for your sessions
*
In Person (Vashon Only)
Phone
Video Conference
Occupation
Referred By
What is your main reason for seeking support?
*
What are your biggest challenges when it comes to this issue?
*
Have you gotten support for this before? What was your experience?
Are you ready to invest not only money but time, energy and heart into resolving this?
*
Yes
Not Yet
Not likely
What do you hope to get from our time together?
*
Do you feel like you are coachable?
*
Yes
Somewhat
Not really
When working with someone to get results, who is responsible for those results?
*
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