Name
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First Name
Last Name
Email
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To know a little about you, please select your age range:
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18-24
25-34
35-44
55-64
65+
City, State, and Country where you reside (Please answer all parts to identify your timezone):
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Where did you learn about Mandi Scovern Coaching and Wellness?
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I would love to know your social media handle:
On a scale of 1-10, how committed are you to investing your time, energy, and resources into making meaningful changes in your life? (1 = Not ready at all, 10 = Fully committed and ready to take action) If less than a 10, what might be holding you back from fully committing to your transformation at this time?
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What is one specific goal you are currently struggling to achieve? How long have you been struggling and trying on your own. Be as detailed as possible.
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What are the top three factors that have prevented you from making the desired change you are dreaming of?
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What is one reason this goal is so important to you to achieve now?
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Have you ever worked with (check all that applies):
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Therapist
Coach
Other:
What do you look for in you ideal DREAM coach? Check all that apply:
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Someone who respects my privacy and my space.
Someone who sends me multiple check-in texts.
A coach who is firm with me and isn't afraid to give me tough love.
A coach who is supporting but gentle with me.
Someone who is super responsive.
A coach who shares their own experiences, creating a sense of connection and relatability.
A coach who embraces my uniqueness and encourages my individuality.
A coach who celebrates my progress, no matter how small.
Other:
And the best for last: Tell me who you are without mentioning your job or your relationships. What are your vulnerabilities, strengths, and weaknesses? How do you see yourself in the world, and what does that mean to you?
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Here is an example:
I’m a determined woman who struggles with self-doubt and a tendency to overthink my decisions. My strengths lie in my creativity and resilience, which help me tackle a busy career. I aim to be a supportive friend, prioritize personal growth, and stay true to myself. Each day, I’m working on loving myself more. I long to be more organized.
Now your turn...you've got this!
Thank you for applying!
I’m so honored you’re considering this next step in your journey with me. Your application has been received, and I’ll be reviewing it with care.
If we’re aligned to work together, you’ll hear from me within 48 hours with next steps.
In the meantime, know this: you’ve already taken a powerful step toward your transformation—and I’m so proud of you and cheering you on!
With empowerment & purpose,Mandi Mandi Scovern Coaching and Wellness LLC