Qualifier Form

Please take a few minutes to complete this form. Your responses will help me understand your needs and goals, ensuring that our coaching sessions are effective and aligned with your aspirations.

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Full Name

Email Address

WhatsApp Number

Age

18 to 25
25 to 35
35 to 45
45+

Profession

Designation

City

What specific challenges are you facing in gaining productivity, managing stress, anxiety, and overthinking in your work and personal life?

On a scale of 1-10, how significantly do these challenges impact your professional and personal well-being? (1 = Minimal impact, 10 = Extremely significant impact)

Are there any specific incidents or patterns in your life that have contributed to your struggles with procrastination, self-doubt, stress, anxiety, overthinking, balancing life and work, or emotional well-being?

Rate your current level of satisfaction with how you manage your productivity, stress, anxiety, overthinking and your overall emotional well-being: (1 = Very dissatisfied, 10 = Very satisfied)

How open and committed are you to implementing new strategies for eliminating procrastination, reducing stress, managing anxiety, and overcoming overthinking/negative beliefs? (1 = Not committed, 10 = Fully committed)

Not and and

Have you worked with a life coach or any other personal development professional before? (Yes/No) If yes, please briefly describe your experience and the results achieved.

What do you hope to gain from coaching when it comes to overcoming procrastination, building self-confidence, and boosting productivity? What would a successful transformation in these areas look like for you?

Are you ready to shift your mindset, break free from procrastination, and overcome self-doubt to boost your productivity?

Yes, I am open to explore
No, not interested

Are you ready to invest in your emotional well-being, stress management, and personal growth? Choose your range:

By submitting this form, you acknowledge that the information provided is accurate to the best of your knowledge, and you agree to engage in coaching sessions based on the details shared.

Yes, I agree
No