Application for Discovery Session-The Stress Free Mom MD

Free Discovery Pre-Call Application

Your Name(*)

Please let us know your name.

Your Email(*)

Please let us know your email address.

Phone Number(*)

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Tell Us A Little About Yourself: What Are You Currently Struggling With?(*)

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Why are you reaching out now, and what is it that you would you like to get from this call?(*)

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If You Had It All Your Way, What Would Your Life Look Like Right Now?(*)

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If You Could Create that Life (or something very close to it), would it be worth investing in yourself to get those results?

Yes, it would absolutely be worth investing in myself to get those resultsI'm unsure if it would be worth making an investment in myself to get that lifeNo, I do not think it would be worth investing in myself to get that life. Invalid Input

Are you at the Cause or the Effect of your Life?(*)

I know I'm at the source of my life, I just need a little guidanceI know I'm at the source of my life, but it feels like I'm at the effectI'm powerless to change my circumstances Invalid Input

Right Now I(*)

Am At The End Of My Rope & Willing to Do What It Takes to Get BetterAm not at the end of my rope, but don't want to burnout, therefore I'm willing to do what it takes to prevent that downward spiralAm Fine Where I am and don't feel I need to take any action. Invalid Input

In General I(*)

Regularly step outside of my comfort zone to achieve what I say I wantAm willing to step outside of my comfort zone to get what I want, even though it feels scaryAbsolutely am unwilling to do anything outside of my comfort zone; I'd much rather stay where I am Invalid Input

Are you ready to take action to get the results you say that you want?

Yes, I'm ready to take action now to get my time, joy, and freedom back, and I have the resources to invest in myself! Yes, I'm ready to take action now, to get my time, joy, and freedom back, and I can get the resources to invest in myself!No, I'm comfortable enough where I am. I'm not ready to take any action or invest in myself. Invalid Input

Will You Answer the Phone At Your Scheduled Call Time? If so, Please Type: "I will answer the phone at my scheduled call time"

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