You’ve taken the first step on your path to peak performance and peak success.

To help me understand where you are and how I can be helpful, please answer the questions below honestly.

Your answers will help me prepare for our call, and to get you in the mindset of acknowledging your goals and envisioning your highest success and fulfillment.

Name

First Name

Last Name

How did you hear about Dr. Yishai?

Email Address

What prompted you to seek out coaching with Dr. Yishai? How long have you been thinking about coaching?

Have you done any work to develop yourself as a founder, entrepreneur, or executive (any specific area/issue or in general)?

Yes

If Yes, what kind of work?

On a scale of 1 - 10, how important is it to you to overcome your limits and reach your potential? *

1 - It's kind of important, but not a priority. 5 - I'm on the fence and trying to figure out my priorities. 10 - Very important. I want to work on this now.

Tell me about why it is important to you. What do you envision will change when you reach peak performance and overcome your challenges and limits?

How much overcoming your challenges and reaching your potential worth to you in terms of time, dollars, energy and results?

Are you actively seeking a coach?

Yes

What areas of your life/business will be affected by overcoming your limits and reaching peak performance and success??

Are you ready for a deep, meaningful, no-excuses coaching experience that will powerfully transform your life?

Yes

**Disclaimer

Dr. Yishai is a psychologist, but not your psychologist. You understand that the Services will be Coaching only, and any consultation being provided is specifically designed for coaching purposes only. By proceeding, you understand that this consultation is not for Psychotherapy, psychoanalysis, psychological counseling, or behavioral therapy services and no therapy/patient relationship or privileges apply.

I Understand and Agree.