Energy Business Coaching – Healing Institute

First and last name

E-mail address

Phone number

Date of birth (dd/mm/yyyy)

Time (hh:mm) and place of birth

What situation are you in now and what do you think you need?

What is your no 1 goal?

What obstacles stand in your way of achieving this goal?

Why didn't you start or what is bothering you?

What do you want to avoid at all costs?

What's stopping you from getting started?

What do you want to achieve in: 3 months, 6 months, 1 year?

What do you find most challenging?

How motivated are you to change?

To what extent are you able to commit?

Are you ready to invest in your development now?

Have you used other forms of help such as coaching, psychotherapy, energy work, constellations?

If so, which ones? When?

Do you now use other forms of support?

Are you ready to take full responsibility for yourself and your process?

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