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9
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1
Name
First Name
Last Name
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2
Email
example@example.com
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3
Where are you located in the World?
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4
What is your deepest heart's desire?
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5
What would you most like to create in the world?
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6
How will you feel and what will change in your life when you create this?
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7
What do you perceive are the main obstacles you are facing in creating this?
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8
On a Scale of 1 to 10 how ready are you to work on shifting these obstacles?
1 being 'I'm not ready at all' and 10 being 'I'm ready to start today!'
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9
What would you most like to receive from our time together?
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