I bet you feel a little bit proud of yourself as well. You will feel even better in a few minutes, when you send this form to me. You will have taken an action step to learn something new, and in filling out the form you will have thought a little about your life, in a way that you don't often do.

I will call you by phone to arrange a suitable time for your coaching session. If you have preferences about what times I call, or if you prefer me to make suggestions of suitable times by email, put this in the comments box at the bottom.

Where you are asked to rate something from 1 to 10, 10 means you cannot imagine any way that things could be better.

The only fields that must be filled in are the ones that I need to contact you, but the more you fill in, the more likely it is that you will get maximum benefit from the coaching session. If you want to ask questions before sending the form you can email me at mailto:tony@mypowerfulmind.com  

I value your privacy. All of this information is confidential between us, and will never be shared with anyone else.