DRIVEEASE PROGRAM - M Club Health & Wellness Centre

Book your Complimentary Intro Call with Shayraz Khan now.

Duration: 15 minutes
Date:
Time:
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Name: *
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Cell Phone: *

Looking forward to connect with you.  Please take NO MORE THAN 5 MINUTES to answer a few intake questions. 



How high is your driving anxiety out of 1000?

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How long have you had driving anxiety?

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What is ideal realistic outcome you are looking for? (Passing road test, driving freely on highway etc.)

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How high sincerely is your motivation to overcome your driving your driving anxiety?

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What wouldn't happen if you don't learn to drive with confidence? How will your lifestyle be effected? (emotionally, financially physically and socially) 

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How much have you spent and plan to spend in driving lessons in trying to eliminate or reduce the driving anxiety? 

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When would you sincerely like to get rid of driving anxiety  completely? 
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How would it make you feel if you had absolutely no fear behind the wheel? (Please describe in detail the benefits of getting over the fear)
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We sincerely thank you for taking the time to fill out the form. You have taken the first step towards your driving freedom. We will review your questionnaire and connect with you shortly. “What you seek is seeking you.” Rumi