Magic Momentum Intake Form

Name *

First

Last

Email *

Contact Number *

What short-term goals would you like to accomplish in first 3 months of 2023? *

What long term goals would you like to accomplish in 2023? *

On a scale of 1 to 10, how much thought of not accomplishing your goals bothers you? *

What are 5 things that you feel are hindering you from achieving happiness, fulfillment, feeling motivated, etc? *

How will you feel if you had the support and accountability required to acheive your goals? *

Do you exercise (Yoga/gym/walking/running/dance) on daily basis? *

Are you willing to put in 1-2 hours of work every day for 4 weeks, towards building momentum and reaching your highest potential? *

How did you find us? *

Fill this form so I can get to know you better, after the form is filled you will be directed to my calendar to book 30 min complimentary discovery call!