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Your answers to essential questions help you identify your confusion, define your challenge, explore your options and create your action plan. We'll create an analysis of your relationship for you. Your score serves as the foundation for answering questions and prompts that are used to design your action plan. This form also serves as the brief mentors review before starting your consultation and working toward to a solution. At your consultation you'll get practical one-on-one advice that you access at critical intersections of personal or professional confusion. It's like having a coach on call.
First Name
Last Name
Email
Phone Number
Tell us a little bit about what is going and how you think we can help.
What is your ideal resolution for this issue?
On a scale from 1 to 10, how strongly do you believe in your ability to reach your best-case scenario?
1 (I Don't Think I Can Do It)
2
3
4
5 (Maybe I Can Do It?)
6
7
8
9
10 (Nothing Can Stop Me)
On a scale of 1 to 10, how would you rate your current wellness score?
1 (Chronic Issues, Debilitating Disease)
2 (Experiences Related to Domestic Violence and Abuse)
3 (Struggles with Alcohol or Drugs)
4 (Neurodivergent)
5 (Stressed But Functioning)
6 ( Pretty Good)
7
8
9
10 (Couldn't Be Any Better)
I'll tell you more in confidence
How supportive are your relationships regarding the changes you're aiming for, on a scale from 1 to 10?
1 (I Haven't Told Anyone)
2
3
4
5 (I Have Some Support)
6
7 -
8
9
10 (Everyone is On Board)
Change takes time; where are you on your decision journey?
1 - I'm just thinking about it and would like some coaching
2
3
4
5 We could use some mediation to help us negotiate our next steps
6
7
8.
9
10. We have negotiated everything and are ready to create new agreements
How technically savvy are you on a scale of 1 to 10?
1 (I can barely use my email)
2
3
4
5 (I am pretty good at searching the web if I get stuck)
6
7
8
9
10 - I can code
Which experts are you interested in collaborating with? Feel free to select multiple options, as they are all included.
Coach - explore options and create your action plan
Mediator - help negotiating your plan into an agreement with someone else
Private Judge - create new legally binding agreements
Money Buddy - bill pay, cashflow, asset and debts, retirement or pensions, investments
Real Estate Mentors - selling house, buy outs, re-financing
Parenting Pathfinder - scheduling, communications, child support
PeaceProvokers - help address conflicts, practice Non-Violent communications
Wellness Watcher - get extra support to manage physical and mental health
On a scale of 1 to 10 how financially complex is your situation
1 We can't talk about money
2
3
4
5 We need some help negotiating
6
7
8
9
10 We are in agreement when it comes to money
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