Apply for Coaching with Dani — Dani Derikx

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Congratulations on taking your first step! I can’t wait to connect with you. Please take some time to fill out the form below, so I can get to know you a little better. I’ll get back to you in 2-3 business days to schedule a FREE orientation call.

Thank you x Dani

Name

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Package of interest

What makes you seek out a mindset coach?

What makes you reach out to me specifically?

What are the top 3 biggest challenges you feel you’re facing at the moment?

What would it mean to you if you could overcome these challenges?

What does being committed to the coaching process mean to you?

How strongly do you agree with the following statement: I am ready to invest both time and resources in the change process

Strongly Agree

Agree

Disagree

I'm not sure yet

How soon do you want to get started?

How did you find me? If you used google, I’m curious what search words you used!

Additional message or questions

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