Name
*
First Name
Last Name
Email
*
What results and benefits are you enjoying as a result of working together?
*
What does your life look and feel like now that we've worked together? What has changed for you?
*
List the 3 most significant improvements you've experienced thanks to our coaching.
Examples: Improved sleep, feeling calmer, better capacity to deal with emotions, changes in menstrual cycle, changes in perspective/mindset, etc
What did your life look like before you began working with me? What did you struggle with?
*
What did it feel like to struggle in this way?
*
What was different about working with me that really worked for you? What really surprised or delighted you about the coaching/treatment you received?
*
Take me to the moment when you realized that the treatments/program were working.
*
What did you do to make these amazing results happen?
*
Example: Changes in diet, mindset shifts, commitment, etc
Is there anything you’d like people to know about working with me?
What could I do better? (Please be honest and specific, so that I can use this information in a productive way.)
Is there anything else you'd like me to know?
Based on your answers, I would love to write a short testimonial using your own words to publish on my website. Do you agree to this?
If you agree to a testimonial, would it be ok for future potential patients to contact you if they have questions about working with me?
Your testimonial would be published with your first name
