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First & Last Name
What city, state, and country do you live in?
Have you ever received life coaching before?
How did you hear about life coaching with Bernetta?
Why are you interested in receiving life coaching?
What are the top three things you want to change or accomplish within the next 3-6 months?
Name at least two dreams you believe you must accomplish in order for you to feel alive, accomplished, and inspired?
If money and time were not an issue, what would you be doing for humanity?
What obstacles are standing in the way of you achieving these dreams and goals?
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