Name
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First Name
Last Name
Phone
*
Country
(###)
###
####
Email
*
Age
*
IG handle or Social Media (if applicable)
How did you hear about 1:1 Coaching?
*
Please select
Social Media
Podcast/Blog/Substack
Referred by Shantani Moore
Referred by someone else
Website/Web Search
Birth Date
*
Please select
Not sure yet
Capricorn
Aquarius
Pisces
Aries
Taurus
Gemini
Cancer
Leo
Virgo
Libra
Sagittarius
Scorpio
Birth Time
*
Please select
Not sure yet
Capricorn
Aquarius
Pisces
Aries
Taurus
Gemini
Cancer
Leo
Virgo
Libra
Scorpio
Sagittarius
Birth Location
Please select
Not sure yet
Capricorn
Aquarius
Pisces
Aries
Taurus
Gemini
Cancer
Leo
Virgo
Libra
Scorpio
Sagittarius
Tell me what you love about your work:
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Tell me what feels annoying or challenging in your work life/business:
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Besides career/business, you'd like to feel more grounded in your:
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Please choose your top 3. We'll chat more about this another time.
Have you received coaching before?
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Yes, I've had a 1:1 coach.
No, this would be the first time.
I've worked in group containers before, but this would be the first time 1:1.
In other coaching containers, tell me what was inspiring & supportive. Then tell me anything felt unsupportive for you:
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If you've never had coaching before, please share your thoughts on the type of support you would like.
Tell me which phrase feels most like you:
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I work slow & steady, taking my time building new ideas.
I crave structure and I don't hesitate to reach out (as long we have a strategy)..
I have tons of big ideas, and need someone who will help me sort them all (no matter how wild they may be).
I'm mostly self-sufficient, I'll do the work, and am excited to show up to calls etc.
Tell me how long you've been in your current career/business:
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0-1 year
1-2 years
2-4 years
4+ years
Tell me about your relationship to burnout:
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Yes, I've been burning out in my business and want to feel better.
Sometimes, it depends on the season (ie: launches, industry demand, etc).
Not in my business, but in other parts of my life - YES.
No, I'm not experiencing burnout.
Tell me which topics (if any) are OFF LIMITS during our time together:
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Anything else you would like to share:
I'm not interested in getting on a sales call to sell you this program. I will sometimes request to chat further to learn more about the specific support you need. Would you be open to a 15-minute call?
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Yes, please. I'd like to chat, ask questions, and feel what it is like to work with you.
No need - I'm ready to sign up now!
I'd like to connect via Slack or just text instead of a call.
The cost of 1:1 is $2000/month for 6 months. I offer payment plans and discounts for paying in full. Tell me about your level of investment in our work right now:
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