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Ready to Crush those Goals?
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First Name
Last Name
Date of Birth
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Cell Phone
Email Address
City
Region/State/Province
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1. What goals would you like to achieve and why? Be specific.
2. How would achieving your goals change your life?
3. In which areas of your life are you lacking balance?
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Required
Physical (Exercise, Nutrition, Rest)
Mental (Stress, Emotional, Cognitive, Coping)
Social (Relationships, Support Systems, Community)
Spiritual (Connection, Purpose, Mindfulness, Gratitude)
Financial (Security, Stability, Sustainability)
Intelectual (Personal Growth, Learning, Creativity)
Professional (Career, Business)
4. What challenges or obstacles do you face when trying to achieve goals?
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Procrastination
Maintaining Routines
Setting Boundaries
Imposter Syndrome
Time Management
Not Sure Where To Start
Other
5. List any other challenges you have with achieving goals or creating balance in your life.
6. What brings you Peace & Happiness? What are you passionate about?
7. What's your occupation?
8. What's the best way to contact you?
If I cancel within less than 24 hours, or no show for my free 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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