Life & Fitness Coaching Questionnaire

Health Education and Life Coaching Form

I’m extremely Selective About who I work with when it comes to consultations or coaching,
so please be as thorough and honest as possible.

Full Name*
Email*
Gender*
Age*
Location*
What is Your Main Objective by working with Thomas Deauer*
Thomas is an overall Success Optimization Coach - What areas of business, family and health are you looking to achieve balance in?*
Of the four pillars that round out a person's success, list the order in which these pillars fall within your life: Family, Business, Health, Mindfulness/Spirituality*
What are you willing to do to achieve balance in your life?*
Working with Thomas is a Significant Investment in Commitment, Are you sure you're ready to commit? Please state Why*
Have you ever worked with life/health/business coach before?*
Of these four choices, which would you say you are seeking Thomas' help with the most: Business/Marketing, Health, Relationships, Fitness/Physique?*
Are you currently in a relationship?*
If yes to #12, How does it affect your ability to get healthy and be successful(positively or negatively)?*
Would you say that people "notice" you in a crowd?*
How important is financial success to you (It's not a trick question)?*
What do you like most about Thomas' style and why do you seek his mentorship?*