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First Name

Last Name

Email

What best describe you?

Life / Wellness / Business Coach

Entrepreneur

Artist / Healer / Creator

Something else

I’m not sure, I’m still working it out

What stops you from taking action in your business?

Not sure where to start

Worried I’ll get it wrong

Money

Time

What does success look like for you (e.g. freedom, clients, time, money)?

What is the biggest challenge that is holding you back?

What is holding you back now?

Self-doubt

Developing my program

Sharing my message

Knowing what to do next!

Do you have a clear plan of where you want to go in the business and how to get there?

Yes

No

How important is it that you succeed?

It’s everything to me! I have to make it work soon!

Really important.

It’s my side hustle, so happy to take my tiime!

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