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What is your employment status?
What is Your employment status?
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Self-employed
Employed full time
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In-between jobs
Semi retired
Retired
What are your main reasons for looking for a life coach?
Select all that apply.
What are your main reasons for looking for a life coach?
*
Feel like a man
Be a better man
Be a better father
Be a better husband
Learn listening tools
Learn communication tools
Change poor behaviors
Discover my career path
Discover my purpose
Get through a crisis
Navigate a major life transition
Help finding a life partner
Improve my relationship
Save my marriage
Reconcile damaged relationships
Find a spiritual path/practice
Get support before/during/after divorce
Grieve a loss
Be happy
Feel joy
Be happier in my own skin
Get unstuck and get on with my life
Determine whether to stay in my relationship
Other
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?
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Still in process
< 1 year
< 5 years
< 10 years
Do you have children?
Do you have children?
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What are the ages and genders of your children?
What are the ages and genders of your children?
Generally, how are you feeling these days?
Select all that apply, even if infrequently.
Generally, how are you feeling these days?
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Angry
Sad
Full of shame
Stuck
Scared
Just plain worn out
Lonely
Anxious
Like I'm living without a road map
Depressed
Confused
Like I just want to quit
Lost
Numb
Overwhelmed
Lacking motivation
Embarrassed
Reluctant to ask for help
Ready to make a change
Other
Please elaborate on how you’ve been feeling recently
Please elaborate on how you’ve been feeling recently
What best describes your current activity level?
What best describes your current activity level?
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Active
How’s your diet?
How’s your diet?
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Super clean
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Terrible
What else do you want me to know about you before we start?
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?
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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?*
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Wayne's Book
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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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