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Pre-Breakthrough Questionnaire

Your pre-breakthrough questionnaire helps Zachary understand where you are now and where you want to go, so every minute of the day is built around you. It takes around 30 minutes, so find a quiet moment and give it your full attention.

What is your full name? *

What is your email address? *

Will you be attending the dinner after your breakthrough day at 6:30pm? *

Yes

What motivated you, or what is your compelling reason, for attending this day? *

What is the ONE MAJOR block or issue, fear or phobia you are experiencing? *

How is this impacting your life? *

What do you believe about yourself in relation to this issue? *

What have you done to try and resolve this? (List all) *

What is most important in your life? *

What is something you are extremely proud of in life? *

What are you most grateful for in life? *

Write a short life history including any events that were significant to you, both positive and negative. *

What patterns have you noticed occurring in your life so far? *

When this pattern shows up, what usually happens just before it? *

What do you think this pattern has been protecting you from? *

What do you currently have in your life that you no longer want? *

What do you not have in your life that you now want? *

If you could have anything as a result of doing this session, what would you want? *

What will be different in your life once this is resolved? *

Imagine it’s the end of the day after our session, and it’s been one of the best days you’ve ever experienced. What’s now true for you? *

On a scale of 1–10, how committed are you to making this change? *

List 3 songs that pump you up *