ADHD AWARENESS MONTH VIRTUAL CONSULT - ADHD CoachConnect

Book your ADHD AWARENESS MONTH DISCOUNT FIRST STEP today with convenience!

Duration: 40 minutes
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Welcome to the first step in your journey for support!  We are so excited for you to take advantage of our 20/20 discount throughout the month of October!


NAME:  {"type":"text","name":"NAME","width":70,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}


1.  How did you find us?  

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2.  What are the challenges being faced? 
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3.  What is the #1 goal/thing most important to you today?
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4.  Is this regarding yourself?  If YES, please skip the next question{"type":"radio","name":"regarding","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","options":"YES\nNO"}


5.  If this is regarding a teen, please check all that apply
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6.  Best way to reach you?  {"type":"text","name":"phone","width":30,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}


7.  What do you want it all to look like with changes implemented?  What is your goal/dream/outlook?  
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9.  Would you prefer to be added to our email newsletter tribe? YESNO{"type":"select","name":"__generic","width":10,"value":"","size":"Normal","validation":"","validationMessage":"Please make a selection for this item.","options":"\nYES\nNO"}

 

10.  Anything else you wish for us to know?{"type":"text","name":"__generic2","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}















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