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Peak Performance Coaching Intake Form

This allows Executive Peak Performance Coach, Christian to see how he can serve you best!

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Question 1 of 11

What Is Your Company Name & Industry?

Question 2 of 11

What Is Your Company Position?

Question 3 of 11

Biggest Obstacles or Struggles?

Question 4 of 11

What Will Happen If This Problem Continues For The Next 12 Months?

Question 5 of 11

What Will It Cost You If You Do Nothing To Fix This?

Question 6 of 11

Out Of All The People You Could Have Chosen To Work With, Why Choose To Work With Christian?

Question 7 of 11

Christian Doesn't Work With A Lot Of Clients Due To Them Getting Massive Results From Intentional Focus From Him. What Would Make You A Great Client For Christian?

Question 8 of 11

Will You Apply Everything Christian Tells You To Apply For Peak Performance?

A

Yes - I Will Apply Everything Christian Asks Me To Do For World-Class Results

B

No - I Will Only Apply What I Think Is Helpful From Christian

Question 9 of 11

What Is Your Monthly Household Income?

A

$0-$30,000/month

B

$30,001/month-$55,000/month

C

$55,001/month-$80,000/month

D

$80,001/month-$100,000/month

E

$100,000/month-$250,000/month

F

$250,000/month+

Question 10 of 11

What Monthly Investment To Work With Christian Would Cause You To Quit On Your Journey To Mastery With Him?

(Select all that apply)
A

$20,000/Month

B

$15,000/Month

C

$12,500/Month

D

$10,000/Month

E

$7,500/Month

F

$5,000/Month

G

None Of These Monthly Investment Amounts Would Stop Me From Working With Him

Question 11 of 11

What's Your Best Phone Number To Be Reached In Case He's Unable To Reach You Via Email?

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