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"You Deserve Peace & Happiness!"
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Your Peace & Happiness Starts Here!
Complete this form and click submit to book your clarity call.
You will be taken to our online booking site.
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First Name
Last Name
Date of Birth
Referred by
Cell Phone
Email Address
City
Region/State/Province
Postal / Zip code
1. What brings you Peace & Happiness? What are you passionate about?
2. What obstacles or challenges do you face when pursuing Peace & Happiness?
3. What are your wellbeing goals? Be specific.
4. Why is it important to achieve your wellbeing goals?
5. Which areas of your wellbeing would you like to improve?
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Required
Physical (Exercise, Fitness, Nutrition, Rest, Health, Positive Relationships, Support Systems)
Emotional (Stress Management, Personal Growth, Creativity, Resilience, Spirituality, Purpose, Mindfulness, Gratitude)
Financial (Career, Business, Security, Sustainability, Literacy, Prosperity)
6. What challenges or obstacles do you face when trying to achieve your wellbeing goals?
*
Required
Procrastination
Maintaining Routines
Setting Boundaries
Imposter Syndrome
Time Management
Not Sure Where To Start
7. List any other challenges or obstacles you experience.
8. What's your occupation?
9. What's the best way to contact you?
If I cancel within less than 24 hours, or no show for my free clarity call/consult call, I agree to pay a $59 cancelation fee.
I give consent to receive life balance consulting services from Zenlae, LLC. I assume full responsibility for services rendered and release the service provider and Zenlae, LLC from any liabilities or damages. I hereby hold harmless and indemnify the consultant, their principals, and agents from all claims and liability whatsoever.
Optional Photo Release: I grant Zenlae, LLC its representatives and employees the right to take photographs of me in connection with services received. I authorize Zenlae, LLC, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Zenlae, LLC may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. I have read and understand the above.
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