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first and last name

email

location

how you heard about me

Have you or someone in your family been diagnosed with ADHD? *not required to join*

Are you an entrepreneur or business owner? If so, what is your business? If not, what do you do for a living?

How is ADHD impacting your work and/or personal life?

What do you hope to achieve by coaching with me?

phone number

thank you!

I'll reach out to you shortly to discuss your application. 

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