Please fill this out — I’ll get back to you on WhatsApp as soon as possible.
If you don’t hear from me within 24 hours, it likely means I couldn’t find your number.
In that case, feel free to reach out to me at [email protected].

Full Name *

Whatsapp (including country code) *

Email *

Age *

1. What’s your main goal right now? *

2. Why is now the time for you to finally change this — and how committed are you from 1–10? (please explain) *

3. What’s your biggest challenge or pattern keeping you stuck? *

4. If we both felt this was the right fit, is there anything coming up that would realistically prevent you from taking full ownership and prioritizing this right now? *

5. Anything else you would like to share?

By checking this box, I consent to receive transactional messages related to my account, orders, or services I have requested. These messages may include appointment reminders, order confirmations, and account notifications among others. Message frequency may vary. Message & Data rates may apply.Reply HELP for help or STOP to opt-out.

By checking this box, I consent to receive marketing and promotional messages, including special offers, discounts, new product updates among others. Message frequency may vary. Message & Data rates may apply. Reply HELP for help or STOP to opt-out.