Pre-consult Questionnaire

    This questionnaire is intended to generally inform the initial consult or first coaching session. Preferences may be modified based on insights gained during the consult. If you'd like to purchase an initial consult or a coaching package, please submit the pre-consult questionnaire subsequent to making your purchase in the shop. Please email your inquiries to, or call us at (212) 369-3128.

  • Extra Info

    If you selected the personalized package please list up to three prioritized areas you'd like to address through coaching. If you are interested in areas that are not in the existing packages, please identify them.

  • If you were referred by a friend, colleague, or other source, please identify the person or organization: