Consultations Intake Form

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Preferred method of communication: video chat/phone, in-person?

Why have you decided to order your first-class lifestyle consultation?

What are your top three complaints about your life?

What are your top three successes in your life?

What planning system do you currently use?

What planning systems have you used?

What do you want to be even you grow up?

Do you have a personal mission statement? Would you like one?

Have you defined your values? Would you like to?

Do you know your life’s purpose? Would you like to?

What would you like to gain out of our time together?

What would you like to avoid?

Anything else you would like me to know about you to help me understand you better?

Make A Plan.