Discovery Call Application Form

Thank you so much for taking the time to complete this form. Your answers are 100% confidential and are only used for the purpose of getting to know you a little more so I can best direct our time together during our call. 

Name *
This helps me determine the best way to connect with you!
If you are outside of the United States or Canada, I will send you a Zoom link to join our conversation online.
What prompted you to reach out to me?
Please include both traditional and alternative modalities.
Please be as specific as possible. List a typical day of breakfast, lunch, dinner and snacks.
Don't hold back here. The bigger the better!
Be optimistic! What do you truly desire?
On a scale of 1-10, 1 being not motivated and 10 being incredibly motivated.
If you were referred by an individual, please provide their full name.