First Name
Last Name
Phone
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Email
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What is/are your preferred name(s)?
Social Media handles: (if using)
Time Zone
Age
ProNouns
What or who led you to Juliette and inspired you to reach out?
What are you looking for support with? Please be specific!
What are you hoping to gain from working together?
What has your healing journey looked like so far? Have you worked with a coach, mentor or therapist before?in the past? If so, what was that experience like for you??
What in your life is working well?
What challenge have you overcome that you're most proud of?
What are your greatest triggers?
What in your life are you committed to improving?
Mental
Emontional
Physical
Spiritual
Relational
Family
Life Purpose
Please use this space for anything else you would like to share.
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