Name
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First Name
Last Name
Email
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Phone
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(###)
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What time zone are you located in?
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Pacific Standard Time (PST)
Arizona Time
Mountain Standard Time (MST)
Central Standard Time (CST)
Eastern Standard Time (EST)
I am located outside the U.S.
Where are you located? (i.e. city, state, and country)
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Where did you find us?
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LinkedIn
Instagram
Website
Email Newsletter
Google
Yelp
Referral
Are you an Entrepreneur, Business Owner, or Leader within an Organization?
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Yes
No
In what sector does your business operate? (e.g. tech, beauty, aerospace, mental health, retail, hospitality, etc.)
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What are you currently struggling with as a leader?
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Relationships- Difficulty with communicating needs and boundaries
Fear of failure - scared of failure so you over work or over compensate
Perfectionism- you believe everything has to be perfect which creates more stress
Scarcity Mindset-you believe there is limited opportunity, money, "room at the table"
Fear of Losing Control-you believe if you relinquish control everything will fall apart.
Something else
What is happening in your business/organization that is negatively impacting your well-being?
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Stress ( 100% working, not able to focus on the vision, minimal time to take off, etc.)
Operations (lack of structure, poor systems, minimal organization, unclear expectations, etc.)
Staffing issues (retention, hiring, morale, productivity, guilt around firing, etc.)
Relationships ( poor relationships with peers, poor boundaries, diffculty with communication, toxic work culture, etc.)
Its something else
What is the goal you are looking to achieve?
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How much of a priority is it for you RIGHT NOW to find a solution for your challenges.
How painful is your current career challenges RIGHT NOW? ( i.e. I no longer enjoy my career, my mental health is impacted, I am completely burnout out,)
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Empowering yourself as a leader takes time, money, energy, and a willingness to grow. How much are you willing to invest for the necessary strategies, support, and accountability to achieve your goals?
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I currently don't have a budget to invest in my goal
I can invest up to $2,000
I can invest between $2,000-$3,000
I can invest $5,000 and up
Lastly, tell us a fun fact about you.
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