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QUESTIONNAIRE
Full Name
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Email Address
*
Phone Number
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How fulfilled do you feel in your current role or business?
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1 - Not at all
2
3
4
5
6
7
8
9
10 - Completely fulfilled
What specifically makes you feel that way?
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Roughly what is your current annual income?
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Less than £30k
£30k–£50k
£50k–£70k
£70k–£100k
£100k+
(We ask this to ensure we're a good fit for you at this stage)
What do you truly want to achieve in the next 12 months — personally and professionally?
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What’s been stopping you so far from achieving that?
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What would it mean for you to achieve that goal — financially, mentally, emotionally?
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Who else would benefit if you achieved this? And how?
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What’s the cost of staying where you are right now?
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On a scale of 1–10, how committed are you to doing whatever it takes to change your situation?
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1 - Not committed at all
2
3
4
5
6
7
8
9
10 - Completely committed
Have you ever invested in personal or business development before? If so, what was the result?
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What made you reach out to Shifts to Success today? Why now?
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Is there anything else we should know about your situation, your mindset, or your goals?
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If accepted, are you in a position to invest in mentorship and support to fast-track your success?
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Yes – I’m ready now
Possibly – I’d like to talk about options
No – I’m not in a position to invest at this time
One More Step
Please find a time here to speak with us to see if we can help you hit your goals!
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