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Full Name
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What short term goals would you like to accomplish in 3 months?
Why do you want to achieve these goals?
Name 1-3 things hindering your happiness.
Name 1-3 things that enhance your happiness.
Have you participated in coaching programs before? Please specify which types.
How do you feel this wellness program can serve you?
How do you feel I can help you succeed as your coach?
How soon are you able to begin the process towards becoming your better self?
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