Pre-Booking Survey

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Services
Blog
About Chi’s
Contact

Thank you for your interest in my coaching program. This survey helps me to understand your current journey and determine how I can best support your transformation.

The Beauty of Doing Nothing: Embracing Quiet Moments

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Name *

First

Last

E-mail *

Phone Number *

Genger

Male
Female
Non-binary

Which program do you want to take?

The Chi-Freedom 4 weeks
The Chi-Freedom 6 weeks
Inner child healing 4 weeks
Inner child healing 6 weeks
Group Coaching sessions

How did you find me?

What inspired you to consider this coaching journey right now?

What’s the #1 area of your life you want to feel more confident in?

Career or business
Romantic relationships
Friendships and social life
Setting boundaries and saying no
Expressing myself authentically
Body image and self-worth
Speaking in public or being visible
Making decisions and trusting myself
All of the above

What do you see the greatest challenge at this time?

What’s your vision for yourself in the next 3 to 6 months?

or there

Have you done coaching or personal development before?

Do you sometimes feel hurt or upset in a way that doesn’t match the situation?

Yes
Sometimes
No

Is there something you keep struggling with in your relationships or emotions?

Are you ready to invest time, energy, and finances into your personal transformation?

Yes, I’m fully ready
I think so, but I have questions
I want to, but I feel unsure
Not yet

When would you like to begin your confidence journey?

Right now – I’m ready
Within the next few weeks
In a month or two
I’m not sure yet

What is your best meeting time?

Morning
Mid-Day
Afternoon
Evening

How flexible is your schedule?

Anything else you'd like to share with me?

Contact

Telefoon: +31 6 28096270
Email: hello@chisconfidence.com

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