Name

Email Address

What is your biggest issue at the moment?

If I could solve it for you how would it change your life?

If I had a magic wand - which three things would you want me to change in your life?

What other coaching or healing have you tried in the past? Did it help?

How committed are you to changing your life? Are you willing to put in the time and effort that is needed?

What Time Zone are you in and what three different times would suit you the coming week?