Intensive Coaching Quarter

Intake Form

Hi! My name’s Jeffrey, and I’m honored to be your coach!

To get started, I want to learn a few things about you that will help me support your getting on the path to success as quickly as possible. This brief form should take about 5-10 minutes to complete, and your responses will not be shared with anybody.

Please answer with as much detail as you are comfortable sharing, as the more I know about where you are in relation to your goals, the more specific I will be able to provide coaching to you. I will cc you with a copy of your responses for your records.

I am usually in New York City, which is EDT.
Price: $ 1,195.00
Focus + Ongoing Support. After you Submit, you will shortly receive a PayPal request for payment. Cancellation any time during the first week will be for a 100% refund.