Questionnaire

Complete Our Questionnaire to Discover if You're the Perfect Match for Beacon Confidential

Name(Required)
I am seeking services for(Required)
Is coaching appropriate for you or the person you are inquiring for?(Required)
Are you open to trying new concepts and implementing new behaviors, even if unsure of the outcome? Do you believe the individual you are inquiring for would be open to this as well?(Required)
Are you committed to doing the work required, including committing to 30-60 minute weekly sessions? Do you believe the individual you are inquiring for is also willing and able to commit?(Required)
Are you able and willing to invest $400 - $600 a month or more for professional, one-on-one coaching? Please note, insurance does not cover these expenses. Does this apply to the individual you are inquiring for as well?(Required)
Is this the first time you are seeking professional advice regarding this issue for yourself or for the individual you are inquiring for?(Required)
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