Please tell me more about you Please allow 15 minutes or more to answer these questions. 1:1 Coaching Questionnaire First Name * Last Name * Email * Phone * Website/URL * Please list your main social media handles * In what City / State / Country do you live? * How do you know about Pauline? Referral Heard you speak Social Media Read your book Purchased your product Other If Other - Please specify. What is your profession? * Are you happy in your current profession? * Yes No What are your Professional Goals? * Do you have a Dream? Would you care to share it? * If Other - Please specify. What are your darkest fears? * Why would you like to be coached / mentored by Pauline Nguyen? * List any relevant assessments you have recently had that could be provided so that Pauline can understand you better. * How old are you? * How old do you feel? * Have you ever had a coach / mentor before? * Yes No Who was your coach / coaches? In what areas were you coached? In order of importance to you, order the following human needs from 1-6. Significance Certainty Variety Growth Love & Connection Contribution * In order of importance, which best describes you? Order the following traits from 1-4. Determined and Driven, Spontaneous and Carefree, Skeptical and Analytical, Always put the needs of others first * What do you want to experience in LIFE? * How do you want to GROW? * What do you want to CONTRIBUTE? * Who is the person you dream of becoming? What does this new version of feel like? * What are your greatest desires? * What do you think is holding you back? * Do you experience pain, dis-ease or disease? * Yes No Is it emotional, mental, physical or spiritual? Tell me more about your pain. What is your reason for wanting to work with Pauline and joining this program? * Developmental work Leadership Spiritual Development Alleviate Pain Other If other, please explain. Submit If you are human, leave this field blank.