Thank you for your interest in working with Michelle. Please take 5-10 minutes to complete this Intake Form, as it helps her get to know you and your goals better.

Full Name

Email *

Phone *

Please share your website and social media handles. *

I want to finally get to the root cause of feeling stuck and as if there's not enough of money, time energy, or love in my life.

YES

I have a specific life or business goal and am serious about achieving it (even if I need some help in clarifying it right now). *

YES

What do you TRULY want in your life and/or business? *

What is your biggest perceived challenge in your life or business right now? Please describe how this is affecting you. *

It's important for me to live my dreams and desires because I know I may live unfulfilled if I don't. *

YES

What do you currently earn per month? What would you like to earn per month? *

I have an "investing in myself" mindset. When I see I need help, I invest the time, energy or money necessary to get the help I need. *

YES, 100%

Please describe how you’ve invested in personal growth, healing work, or coaching in the past. *

Why are you interested in working with Michelle, and why now? *

One of the tools we use at MBC is Human Design. It helps us to help clients make decisions from their own inner authority and True Self. Please share your birth info (day/time/location) so we can be of greatest service to you. if your birth info is not readily available, please write N/A. *

I agree to the Terms & Conditions provided by the company.

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