The first step is taken.
Your call is booked. Please take a few honest minutes to tell me where you are right now, so we can use our 15 minutes on what matters most. Everything you share here stays completely confidential, and nothing here is judged.
16 questions · ~6 minutes
Be honest, not impressive
01 — Current State
On a scale of 1–100, how stuck or overwhelmed do you feel right now?
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02 — Where It Shows Up
Which of these feel closest to what's weighing on you? Select all that apply.
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03 — In Your Own Words
What's going on for you right now?
{"type":"textarea","name":"__generic3","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":"Say it the way you'd say it to a close friend."}
04 — History
How long has this been going on, and when is it at its worst?
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05 — How It Shows Up
How does it show up in your body, your thoughts, and the way you act with others?
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06 — The One Issue
If we could resolve just ONE issue together, what would it be?
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07 — Pressure Test / The Real Block
What's the biggest fear or belief that has kept this issue in place?
This one matters more than it seems.
{"type":"textarea","name":"__generic7","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":"Really think about it."}
08 — Pattern Check
What have you already tried, and how did it go?
{"type":"textarea","name":"__generic8","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":"Therapy, medication, books, apps, exercise... list everything."}
09 — Pressure Test / Cost of Inaction
If nothing changes, what will the next 12 months cost you?
Be specific: health, relationships, money, self-respect.
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10 — Pressure Test / Honest Commitment
On a scale of 1–100, how committed are you to solving this right now?
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11 — Pressure Test / Time
How much time per week can you realistically give to this?
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12 — Pressure Test / Investment Readiness
What feels realistic for you to invest in solving this right now?
Answer with where you actually stand today, not where you wish you were.
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13 — Vision / What Changes
Imagine it's 90 days from now and this issue is completely gone. What does that feel like in your body, your mind, and your day-to-day? What are you doing differently?
{"type":"textarea","name":"__generic13","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":"Just let your imagination run wild."}
14 — Current Support
Are you currently working with a doctor, therapist, or psychiatrist, or taking medication for any of this?
Coaching works alongside professional care, never in place of it.
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15 — Your Safety
In the past two weeks, have you had thoughts of harming yourself or of not wanting to be here?
{"type":"radio","name":"__generic15","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please choose one of the above options.","options":"No\nSometimes\nYes\nI'd rather talk about it"}
16 — How You Found Us
How did you hear about M Health? If someone referred you, please share their name so we can thank them personally.
{"type":"textarea","name":"__generic16","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":"Referral, Google, Instagram, YouTube, event..."}
{"type":"checkbox","name":"__generic17","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please check this box to continue.","options":"I understand this is coaching and does not replace medical or mental health care."}
Final Step
Naming what's really going on, out loud, is where every real shift begins. I'll personally review your answers before we speak. If you're in crisis before then, please call or text 9-8-8 (Canada), any time, day or night.
I'M READY FOR MY CALL
