A Flourish Conversation

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1. What's your name?* This field is required.
First Name
Last Name
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2. What's the BEST email address to reach you?* This field is required.
example@example.com
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3. What's your phone number?* This field is required.
Area Code
Phone Number
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4. What time zone are you located in?* This field is required.
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5. What brought you here?* This field is required.
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6. What is your current profession or business?* This field is required.
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7. Tell us more about your profession or business.* This field is required.
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8. How long have you been in practice/business?* This field is required.
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9. Do you have a website? (if so, please share your link)
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10. What is your NUMBER ONE goal? (the thing that is most important to you that will make all the difference)* This field is required.
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11. What are the biggest challenge you feel you have right now as it relates to money, value, and worthiness? (Please be as specific as possible)* This field is required.
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12. What is your current monthly personal income and/or revenue (if you have a business)?* This field is required.
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13. What would you like your monthly personal income or business revenue to be?* This field is required.
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14. Do you have a retirement fund, savings, real estate or other types of investments?* This field is required.
Yes
No
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15. If money and time were no object, how would you want to contribute your gifts in the world?* This field is required.
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16. What uncomfortable or unfavorable emotions do you experience on a semi-regular or regular basis (as it relates to money or wealth)? (check all that apply)* This field is required.
Anxiousness
Worry
Fear
Guilt
Shame
Anger
Other
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17. Please, elaborate more on those emotions? (Explain as best as you can)* This field is required.
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18. Are you able to financially invest in yourself?* This field is required.
Yes
No
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19. Are you willing to travel for in-person sessions if necessary?* This field is required.
Yes
No
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20. What have you tried in the past as it relates to any of your money, wealth, value, worthiness challenges?* This field is required.
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21. Why are you ready to become an empowered leader?* This field is required.
Yes
No
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22. Anything else you want to share?* This field is required.
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