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First Name

Last Name

Have you ever worked with a mentor before? if so, who and when?

Best Phone Number For Us To Reach You

Briefly describe the services, products or programs you currently offer.

What was your total income for the last 12 months?

What are your income goals for the next 12 months?

On a scale of 1-10 (10 being the highest), how committed are you to meeting your goals within the next 12 months?

What is your #1 biggest challenges in your business right now?

What is your long term vision for your business?

What are the biggest results you would like to see from working with a mentor like Shayla Mihaly?

Why is now your time to transform?

What do you think is stopping you from changing your life?

Is there anything else you would like me to know about you?

Wealthy Women HealersMay 202512 Month Mastermind Application