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What is your employment status?

What is Your employment status?*

Self-employed

Employed full time

Employed part time

In-between jobs

Semi retired

Retired

Please elaborate on why you’re looking for a life coach.

Please elaborate on why you’re looking for a life coach

What best describes your relationship status?

What best Describes Your Relationship status?*

Single and not looking

Single and actively dating

In a relationship (< 1 year)

In a relationship (> 1 year)

Engaged

Married

Married and on the verge of divorce

Divorced

It's complicated

How recent was your divorce?

How recent was your divorce?*

Still in process

< 1 year

< 5 years

< 10 years

Do you have children?

Do you have children?*

Yes

No

What are the ages and genders of your children?

Please elaborate on how you’ve been feeling recently

What best describes your current activity level?

What best describes your current activity level?*

Sedentary

Moderate

Active

Super Active

How’s your diet?

How’s your diet?*

Super clean

Moderately healthy

Not great

Terrible

What else do you want me to know about you before we start?

Are you aware of our fees at BetterMen Coaching?

BetterMen 90-min Evaluation & Coaching Session - $595 USD;
50-min Coaching Session - $395 USD

Are you aware of our prices at BetterMen?*

Yes, I'm aware

I wasn't, but I am now and it's not a problem

How did you learn about BetterMen Coaching?

How did you learn about BetterMen Coaching?**

Wayne's Book

Google

Podcast/Article

Social Media

Friend or Family Member

Other

Let me know how I can reach you.

Once you submit this form, you'll have the option to schedule either a 15-minute consultation (FREE) or a 90-minute BetterMen Evaluation & Coaching Session ($375 USD.) Once you schedule either, you'll receive next step instructions from Wayne. If the available times on Calendly do not work with your schedule, use the Contact form on this site to make arrangements directly with Wayne.

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