Your information:
First Name
Last Name
Phone
*
Email
*
What is the main goal you are aiming to achieve?
What is your profession? Does it involve physical exertion or activity?
What has prevented you from reaching your goal in the past?
Why is now the right time to start making a change?
Rate your motivation to reach your goal:
1
2
3
4
5
How long would you be willing to commit if you could be 100% certain that this commitment would help you achieve your goal?
6 months
6-12 months
over 12 months
Where did you hear about Koutsi online coaching?
Your Instagram handle:
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