$15 Coaching Request Short

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I'm Ready! Reserve My Spot Now!

Name (How would you like to be addressed?)
Email
Phone (For questions and telecoaching)
1. 
What issue is most pressing at this moment? (You can always change your mind.)
2. 
What topic(s) from above is most pressing at this time?
3. 
Feel free to add any relevant details or information here.  (If parenting related, consider adding gender & ages)
4. 
Feel free to add relevant background information.  (If parenting related, please include # of children, gender & age)
5. 
What type of support are you seeking today? (Check all that apply)
6. 

What type of Coaching Support Would You Prefer For This Session? (Choose all that apply.)




Please note: Coaching offers a safe place to open emotionally. Naturally, you may choose to use a session to vent or receive emotional support. This type of coaching session is perfectly acceptable, but offers completely different results (an emotional release) rather than a goal-oriented solution.  If you choose Venting and Emotional Support, Susan is less likely to guide you toward a resolution during this type of session.  But, that's okay!  Coaching sessions are about what you need at that moment.  And if you change your mind, before or during the session, that's fine too!

7. 
Your new question!
8. 
Your new question!
9. 
What Support Are You Seeking ? (Check all that apply)
10. 
How can I help you: (Please check all that apply)
11. 
I prefer to receive this information:
Please confirm you are a real person.   No Bots Allowed!
One last request.  Are you a real person or a bot?

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