Stuch. Life Coaching — Discipline Creates Freedom

Client Application
Take Control of Your Life

Tell us a little about yourself and what you're looking to achieve. Your answers will help determine if Stuch Life Coaching is the right fit for you.

[ 01 ]Contact Information

Let's get started

Full Name *

Phone Number *

Email Address *

City / State *

[ 02 ]About You

Help us get to know you

1. What best describes you? *

Working professionalBusiness owner / entrepreneurStudentStay-at-home parentIn transition (career, relationship, etc.)RetiredOther

2. What is your age range? *

Under 2525 – 3435 – 4445 – 5455+

3. What is your current employment status? *

Full-timePart-timeSelf-employedBusiness ownerUnemployedOther

[ 03 ]Your Goals

What do you want to achieve?

4. What areas of your life do you want to improve? (Select all that apply) *

Mindset / mental clarityDiscipline & consistencyConfidenceStress managementHealth & fitnessCareer / businessFinancesRelationshipsTime managementBreaking bad habitsLife direction / purposeAccountabilityPersonal growthOther

5. What are your top 1–3 goals right now? *

6. What is currently holding you back from achieving these goals? *

[ 04 ]Coaching Preferences

Let's find the right fit

7. What type of coaching are you interested in? *

One-on-one coachingVirtual coachingIn-person coachingGroup coaching / accountabilityNot sure — recommend the best option for me

8. How soon are you looking to get started? *

ImmediatelyWithin 30 days1 – 3 months3 – 6 monthsJust exploring options

9. How often would you like to meet? *

WeeklyBi-weeklyMonthlyNot sure

[ 05 ]Your Commitment

Are you ready?

10. How committed are you to making real changes in your life? *

I'm just gathering informationI'm ready to make changesI'm serious and ready to invest in myselfI need support and accountability

11. Is there anything else you'd like Scott to know before your consultation?

This is the first step toward a stronger, more focused, and more purposeful you. Let's build the life you're meant to live.