Pre-Consultation Questionnaire

To schedule a free consultation to see if coaching is right for you, please complete the brief form below. We will schedule a consultation for you with the coach best suited to meet your needs. Or call 877.880.9100 (toll free) or 678.248.3558 .

Your Name (required)

Your Email (required)


Daytime Phone

Best time of day between 9:00 AM and 5:00 PM (Eastern),
Monday-Friday for the free consult (include your time zone)

How did you hear about us?

Are you currently employed?
 Yes No
If yes, what is your occupation?

If you're not currently employed, do you have enough money
to live on for at least six months?  Yes No

Which do you most need help with:
 I want to determine what I want to do when I grow up I know what I want to accomplish and want help attaining it

Do you own your own business? Yes No

If not, do you want to start your own business?
 Yes No Maybe Already have business

What has prompted you to consider coaching at this time?

What would you like to accomplish through coaching: immediate and long-term goals?

Is there anything else you would like to tell me about yourself?

Please indicate your budget parameters for coaching. (Coaching fees are charged on a monthly basis ranging from $500-$750/month. We also have a Get it Done Package: Virtual Ideal Career Planning Day for those who want to get clarity quickly

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Wishing you happiness and success with your dreams,
Stacey Mayo