Brainstorm and make a list of your dissatisfactions (both personal and business). Include: a. your financial state; b. your level of contribution; c. your morale; d. your quality of communication and engagement; e. your health on all levels; f. the health of your company; g. your reputation, and h. your clarity and confidence in the future direction of you and your company. *

Determine your top three from the list above and enter them below. Why did you choose these? *

Which of the following business and lifestyle challenge symptoms are you experiencing? (CHECK ALL that apply) *

Consider the following questions from Jim Rohn and list your answers below. 1. What can I do right now to begin making progress toward resolving one or more of the challenges or dissatisfactions above? 2. What could I read? 3. Who could I ask? *

On a scale of 1-10 (10 being highest), how important is it to you to break through any blockages and resolve the dissatisfactions and challenges you mentioned? Then state what you think the biggest obstacle is that's preventing you from achieving your breakthrough and living your best life. *

Check the opportunities below (all that apply) by which we can assist you in achieving your needed breakthroughs. *

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