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Please Complete This Brief Questionnaire Before Scheduling The Call
First Name
Last Name
Email
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Phone
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How old are you?
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Occupation:
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How did you find out about us?
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A friend or client recommended
LinkedIn
YouTube
An Ad
Other
What is the main thing you want to enhance in your life right now?
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Energy & physical health
Mental focus & productivity
Emotional well-being / stress resilience
Career performance & decision-making
Sleep, recovery, or nervous system regulation
All of the above
Other
What’s preventing you from achieving that till this point?
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Lack of knowledge
Lack of structure or a proven system
I’ve tried things but nothing really stuck
I haven’t prioritized myself consistently
I’ve been distracted or spread too thin
Other
What have you tried?
Fitness programs or nutrition plans
Cold plunges, saunas, or biohacking
Meditation, yoga, or breathwork
Supplements or nootropics
Performance or productivity courses
Other coaching programs
Nothing yet—I’m just getting started
How soon are you looking to get help to solve this?
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As soon as possible
2-4 weeks
1-3 months
3+ months
