Coaching Prescreen… 1) Rate each of the following Attraction/Relationship areas, from 1- 10 (10 being you can't imagine it could possibly be any better). There’s no judgment here, so be honest. Otherwise we can’t get you to where you want to be! 1 2 3 4 5 6 7 8 9 10 I am attracting the women I really want 1 2 3 4 5 6 7 8 9 10 I feel great/confident about myself 1 2 3 4 5 6 7 8 9 10 I know what I want with women 1 2 3 4 5 6 7 8 9 10 I feel right/good about what I want with women 1 2 3 4 5 6 7 8 9 10 I feel free to ask women out and ask for what I want/need with women 1 2 3 4 5 6 7 8 9 10 I appreciate and respect women. I really care about them as human beings 1 2 3 4 5 6 7 8 9 10 I have access to my emotions and feel “embodied” 1 2 3 4 5 6 7 8 9 10 I feel centered, clear & on purpose in my life and work 1 2 3 4 5 6 7 8 9 10 I feel great about my sexual desires and am free to express myself sexually 1 2 3 4 5 6 7 8 9 10 My relationships with other men are honest and a great support in my life 2) Which of the areas above do you most want change in over the next 3-6 months? 3) Describe what your connections and relationships with women would be like if there was nothing limiting you or holding your back… 4. What three things are you most tolerating or putting up with in your life?      1.      2.      3. Which of these are you ready to handle?   5) Assuming all human beings have some way of holding back or sabotaging our lives, which are your favorite methods? Procrastination Indecisiveness Arrogance/ being right Acting as 'Lone Ranger' Tolerating Not saying "No" Not saying "Yes" Controlling life /people Following secondary goals (i.e. goals that won't ultimately make me happy) Not telling the absolute truth Other: 6) What would you get from coaching that would be most valuable to you? (Choose up to 3) Challenge Accountability Focus Support Inspiration Direction Sounding Board Ideas/ Strategies Validation 7) How coachable (open to input and feedback; comfortable in partnership; ready to make changes) do you suspect you are? Highly Reasonably I'm trouble 8) Primary Interest: Ready to dive into coaching Considering hiring a coach One-off session simply to see what coaching is about I'm not looking for a coach right now 9) If after this complimentary session we decided to work together, what is your preferred start date? Within the next 10 days Within the next 30 days Within the next 3 months 10) Do you require anyone else's agreement before setting up a 3-6 month coaching structure for yourself? No, I can make that decision alone (or have my partner's and/or company's full support) Yes, I would have to get the agreement of my partner or company first 11) Should we decide to work together, how affordable do you feel the coaching investment is for you? * See coaching investment at the end of this form. Comfortable Reasonably, assuming consistent results A stretch, but OK with consistent results I don't see how I could make it work 12) Personal Details Full Name: Email (Please check spelling): Cell Phone: Other Phone: State/Province: Country: Comments:

Coaching Investment:
Coaching rates range from $135 - $175/hour depending on the program you choose.

The Redlight/Greenlight coaching program is a 3 - 6 month program that includes 4 hours of phone or in-person coaching per month and up to 1 hour per month of online coaching.

The normal hourly rate of $175 is discounted to $160/hour for the 3 month program = $1920, and $150/hour for the 6 month program = $3600.

When you pay up front you receive an additional 10% discount on your investment.

The 3 month program becomes $144/hour = $1728
The 6 month program becomes $135/hour = $3240

When signing up for a program you have the option to withdraw at the end of the first month if you are not fully satisfied. (You will be charged the hourly rate for those sessions rather than the program rate.