Worksheet

Private Retreat Coaching Packages Application

This form is to help me get to know you better, so that we can make the most of our time together!

1. ➜

Is this for you?

I am highly selective about who I work with and who I get on calls with, so before we move forward, I have questions for you.

Before I invest my time with you, I want to know that you are already beyond looking for a quick fix and that you are ready to do the work of actually transforming your lifestyle.

Your answers will tell me what I need to know, and whether you’re a good fit for how I work. Do not apply unless you already know that I am the person you want to work with and you are ready, willing and able to purchase the package that is the best fit for you on the call.

2. ➜

First Name

3. ➜

Last Name

4. ➜

E-mail Address

5. ➜

Phone Number

6. ➜

What is your occupation?

7. ➜

Are you willing to make focusing on your health and your weight your central focus and highest priority right now?

If your weight and your health are not currently your highest priority, please apply at a future date when it is.

Yes

8. ➜

Tell me why losing the weight now is currently your highest priority?

9. ➜

Tell me a litte bit about your struggle with weight loss.

10. ➜

What have you attempted in the past that didn't work? Why do you think it didn't work?

11. ➜

Have you ever had success with weight loss? If yes, what worked for you in the past?

12. ➜

Do you take responsibility for the past results you've created with your health and your weight?

Yes

Sometimes

13. ➜

If you said 'sometimes', who or what do you deem to be responsible?

14. ➜

What is your biggest question when it comes to weight loss?

15. ➜

Why do you want to work with me specifically?

16. ➜

What attracts you most to getting the royal hand hold experience?

17. ➜

Where do you want to have your retreat experience (s)?

I live in the Okanagan in BC and I want you to come to my house.

I do not live in the Okanagan and I understand that in addition to the package price, there will be an additional charge to cover travel expenses (airfare, hotel and car rental).

18. ➜

Are you ready to get started right away?

I only speak with people who are all in, willing and able to immediately invest in moving forward. What are you willing and able to invest right now?

$5,000 (plus 5% GST)

$15,000 (plus 5% GST)

$25,000 (plus 5% GST)

19. ➜

If we are a good fit to work together….

Are you willing to invest that amount on the call?

Yes

20. ➜

Anything else you would like me to know?

21. ➜

Get ready to get started!

Make sure that you have credit card on hand to make your payment and your calendar in front of you so that we can nail down our start date before the end of the call!

Save your answers

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Sherry Rothwell