We R all OK Coaching Session

So we can get the best out of our session together, we need you to answer a few questions that will help us understand your challenges and what you are hoping to get out of our session.

Please begin the questions by clicking on the arrow in the bottom right corner.

What is your proficiency in English? *

Proficient

Limited

OK

How old are you? *

Under 18

18 - 25

26 - 40

41 - 60

61+

Do you have a parenting related challenges you would like support with? *

Do you have any relationship related challenges you would like support with? *

Do you struggle with any of these emotions? Click all that apply. *

Anger

Stress

Anxiety

Depression

Overwhelm

Fear

Guilt

No, I'm doing great!

What emotional challenges are you facing? *

How would you rate your connection with Allah? *

Excellent

Good

Slight

Not Good

What challenges are you facing with regards to your connection with Allah? *

Have you ever invested in personal development programs/services/workshops/retreats etc. before? *

Yes

No

What types sort of personal development did you invest in?

Online Program

Group Coaching

One on one Coaching

Online Workshop

in Person Program

in Person Workshop

Retreat

How much have you invested in personal development in the last 12 months (approximately)?

$0-$100 USD

$101-$200 USD

$201-$500 USD

$501-$1000 USD

$1001-$5000 USD

$5001-$10K USD

$10K+ USD

How much would you be willing to invest in lifetime access to all personal development programs and support you need? *

$0-$100 USD

$101-$200 USD

$201-$500 USD

$501-$1000 USD

$1001-$5000 USD

$5001-$10K USD

$10K+ USD

Is there any other information you would like to share with us before we meet?

Personal Details

In order to communicate with you and provide you the best service, please enter these details below:

First Name *

Last Name *

Email *

Country *

Country

Afghanistan
Albania
Algeria
American Samoa
Andorra
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Anguilla
Antarctica
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Armenia
Aruba
Australia
Austria
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Bahamas
Bahrain
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Barbados
Belarus
Belgium
Belize
Benin
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Bhutan
Bolivia
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British Indian Ocean Territory
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Chile
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Cook Islands
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Cote D"Ivoire
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Dominican Republic
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Finland
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French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
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Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and Mcdonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic Of
Iraq
Ireland
Isle of Man
Israel
Italy
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Japan
Jersey
Jordan
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Kenya
Kiribati
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Korea, Republic of
Kuwait
Kyrgyzstan
Land Islands
Lao People"S Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
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Macedonia, The Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova, Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
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Niger
Nigeria
Niue
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Northern Mariana Islands
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Palestinian Territory, Occupied
Panama
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Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
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Qatar
Reunion
Romania
Russian Federation
Rwanda
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Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
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Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
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Sudan
Suriname
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Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
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Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
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UK
Ukraine
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United States Minor Outlying Islands
Uruguay
Uzbekistan
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Venezuela
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Virgin Islands, U.S.
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