Parental Discovery Survey


Thank you for expressing interest in the powerful and profound results that my clients receive as a result of asking me to help them.

I honor the needs of each person I meet and I take the time to read, listen and consider challenges so that I can suggest straightforward, step by step methods to get right to the results.

Would you kindly complete the form below, so that together, we can prepare to make the most of the time I spend together with your son/daughter? 

What age is your son/daughter?

What is the situation with your son/daughter? What specific obstacles and struggles do they regularly come up against? The detail is important here.

What is this costing them in terms of success, opportunity, and emotional unrest?

How does this affect their performance? 

What are they not able to do because of this? 

What are they not able to have because of this? 

What are they not able to be because of this? 

What are you currently trying in order to change this?

In what area of his/her life do you most want to see a true breakthrough?

How will achieving this make a difference?

Where would you like them to be a year from now?

How did you get to hear about my services?