Book Consultation — Jen Kupcho

Authentic Splendor Application for Spiritual Mindset Coaching

What is your full name or the name you wish to be addressed by?

Email Address

Phone number (if in the US)

(###)

###

####

How happy are you in your life right now?

Rate: Not at all 1 2 3 4 5 6 7 8 9 10 I’m in love with it!

Please describe your current life in 10 sentences or less:

Spiritual Mindset work will connects with all aspects of your life. What other specific areas would you like to focus on?

(you may pick as many as you like)

Family

Career

Relationships

Health/Wellness/Weight Loss

Other

Are you currently practicing goal setting?

Yes

Imagine there were no obstacles in life and the sky was the limit; you could have anything you wanted. Describe your dream life (job, relationship, position, love, support, family…) and what it would mean to you.

Share one success you would like to accomplish this year:

What are some challenges or obstacles you believe are holding you back?

Name one of your special skills you are most proud of:

What is an activity, hobby or cause you feel very passionate about?

Would you consider yourself a spiritual person?

Yes

Describe what ‘spiritual’ means to you:

How committed are you in working together to manifest the life you deserve; to fulfill your purpose driven life, find love and joy and step into your Authentic Splendor? Are you willing to show up, follow through with homework and work together as a team?

Sightly committed 1 2 3 4 5 6 7 8 9 10 Give me my life back!!

Thank you for taking the time to fill out the questionnaire. The clearer you are about what you want, the easier it will be for us to get you connected with your purpose, passion and joyful life. It’s your time to step into your Authentic Splendor. I can’t wait to start the journey together.

Jen