Discovery Session Form
[Will Take Approximately 15 minutes to Complete]
BEFORE YOU GET STARTED! I’d like to share, the methods I have developed took years of research and a great deal of time to create for you. I have tiered offerings for our Vixens who have different budget levels. 

If you’re DONE playing small, are ready to fully step into your feminine power with confidence like you've never felt before (in the boardroom AND the bedroom) and you’re determined, at last, to live a juicy first-class life, click “START” below to tell me about yourself.
START
 
Today's Date: *

 
First Name: *

 
Last Name: *

 
Phone/Cell #: *

 
What is your Skype ID?
(For international inquiries ONLY.)

 
If outside the United States, what country do you currently reside?
For International inquiries ONLY.

 
Please share your current relationship status. *


 
Tell me about your BIGGEST love or life challenge, what is your deepest frustration and how is it adversely affecting your life and relationships? (It's important to be SPECIFIC). *

 
Are you struggling at all with attracting (or keeping) money? (For some women, low confidence and unfulfilling relationships can affects income potential!)

     
 
Do you think that your feelings about your love life are starting to affect EVERY part of your life? *

     
 
On a scale of 1 -10, 10 being the most urgent, how important is it to you to resolve this challenge in your life and finally feel the love, the passion, the sexy confidence? *











 
[If in a Relationship] On a scale of 1 -10, 10 being the most urgent, does your partner want to resolve this challenge in your relationship?











 
How long have you felt frustrated, a little sad or unfulfilled? *

Select one (1)

 
What have you tried in the past to address this frustration? *

Select the one (1) that you have invested the most time, attention and money with.

 
What were the results of your past efforts? *


 
Approximately how much money have you invested in the therapy, coaching, personal development programs or retreats? (Cumulative Investment) *


 
If those investments did not yield the result you hoped for, why do you think they didn’t?

 
What is the specific result or outcome you want to achieve to feel happy and fulfilled? *

 
Which of these do you feel most relates to SOLVING your current problem? *


 
How do you prefer to learn? *

SELECT NO MORE THAN TWO (2)

 
Do you have a "commitment to self" mindset? Meaning do you invest the time, energy and money necessary to get the help you need. *

     
 
Are you looking for a quick fix to your challenge that a single session can provide? (Only need insight for concern)

     
 
Are you looking for a complete TRANSFORMATION to your challenge that a coaching program can provide? (Want long-term change)

     
 
What has stopped you from making the change towards being happy? *


 
Rate the following questions from 1 - 10, with 1 being LOW and 10 being AMAZING.

 
On a scale of 1 to 10, how confident are you in attracting MEN? *











 
On a scale of 1 to 10, do you want a man who will SPOIL you? (In terms of money) *











 
On a scale of 1 to 10, how confident are you in the BEDROOM & SEXUAL skills? *











 
On a scale of 1 to 10, how confident are you in your CAREER/BUSINESS? *











 
Which issue is most important to you? *

Select one.

 
Are you ready to invest the time, money and energy to solve this problem? If you're not willing to invest in yourself, it will always be a struggle to get a man (or a company) to invest in YOU. *

     
 
What are you ready to invest now to get what you want? *


 
Is anyone else involved in the decision making of working with me (spouse, parent, another family member, etc.) I ask this because I want to understand the level of support you have. *

 
How did you hear about me? *


Thank you for submitting your request for a juicy Discovery Session with Stacey Murphy, Certified Intimacy & Charisma Coach.  
She will contact you within 24 hours to schedule your session.
Click on the button below to schedule your session.
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