Thanks for requesting a breakthrough strategy session with me. You can either complete the form below online or print it out and write on it.
Please submit it online or return it to me via scan in email or fax (+1.309.422.7665). Once I have reviewed your submission, my team will send you information on how to schedule and prepare for a conversation with me.
Answer all questions frankly, and honestly to the best of your knowledge. (Look, I know what it is like to look at these forms. I have filled out my share too, but if you're not completely honest, we may miss an important point that will lead to your breakthrough!) All information is kept strictly confidential. Your responses help me get up to speed on your situation and be prepared to help you get the biggest breakthrough or a-ha during our time together. As an added bonus, many tell me they receive lots of insight just by filling in the form! Please also know that everything you share with me will be kept 100% confidential.
Note: There are no “right” or “wrong” answers. This is meant to explore what is going on currently as well as help get me information prior to our conversation so that we can make the most of our time together.