First Name *

Last Name *

Your occupation or business niche *

Rate your current energy levels: *

Very High - I feel energetic and vibrant throughout the day; rarely experience fatigue.

High - Generally I have good energy levels but occasionally feel tired.

Moderate - My energy levels fluctuate; I have balanced periods of energy and tiredness.

Low - I often feel a lack of energy and experience regular fatigue.

Very Low - I constantly feel drained and struggle with significant fatigue.

How do you balance your professional success with your personal life? *

Well-Balanced - I effectively manage my professional responsibilities and personal life maintaining a healthy balance between the two.

Somewhat Balanced - I strive for balance but often find my professional life taking precedence over personal time.

Occasionally Balanced - There are moments when I achieve balance but it's not consistent; my professional or personal life can dominate at times.

Rarely Balanced - I struggle to balance my professional success with my personal life; one significantly outweighs the other.

Not Balanced - My professional life completely dominates leaving little to no time for personal activities or relaxation.

Do you have any known health conditions or concerns? If yes, please specify. *

Have you tried any strategies in the past to address these issues? If so, what were they and what were the outcomes? *

What is your primary health transformation goal and why is achieving this goal crucial for you? *

Imagine we were having a conversation 12 months from now, and you were reflecting back to today. What would you consider a highly successful outcome in terms of enhancing your health and well-being over this period? *

How committed are you to achieving your desired health and wellness outcomes? *

Fully Committed - I am completely dedicated and will take all necessary steps to achieve my health and wellness goals.

Highly Committed - I am very serious about my goals and ready to make significant efforts to achieve them.

Moderately Committed - I am committed to my goals but may face challenges in consistently putting in the effort.

Somewhat Committed - While I am interested in achieving my goals I may struggle with motivation or consistency.

Uncertain About Commitment - I am currently unsure about my level of commitment or ability to pursue these health and wellness goals.

How would you describe your decisiveness in health-related matters and your openness to adopting new health and well-being strategies? *

Decisive and Highly Open: I make health-related decisions confidently and am highly open to new strategies and advice.

Decisive and Open: I am confident in making health-related decisions and generally open to trying new methods though I may need some convincing.

Moderately Decisive and Open: I can make health-related decisions but sometimes need extra time or information and am moderately open to new strategies.

Indecisive but Open: I often hesitate in making health decisions but am open to new strategies and coaching.

Indecisive and Resistant: I struggle with making health-related decisions and am hesitant or resistant to new methods and advice.

How willing are you to invest in your personal health and well-being? *

Fully Committed - I am highly dedicated to doing whatever is necessary to enhance my health and well-being understanding its impact on my life and work.

Very Willing - I am prepared to significantly invest time effort and resources towards improving my health and well-being.

Moderately Willing - I am open to investing in my health but I need to balance it with other commitments and responsibilities.

Somewhat Hesitant - I am cautious about investing heavily in my health and prefer to take a more conservative approach.

Not Ready at This Time - Currently I am not in a position to invest additional resources in my health and well-being.

Are there any other specific areas you would like to focus on during your Clarity Call? *

What is your best email address (e.g. the one you most frequently check) *

What is your mobile number? *

You have made or are on the path to incredible achievements in your professional life.

Now it's time to apply that same rigor to enhancing your well-being. Your future self—healthy, energized, and fulfilled—awaits you at the end of our transformative Clarity Call.

We will be in contact to arrange a suitable time.

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