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Q.1
Please provide your full name.
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First Name
Last Name
Q.2
Please provide your email address.
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(e.g. mary@example.com)
Q.3
Please provide your phone number, city, and state. (If outside the U.S., please provide your country and Skype name)
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Q.4
How did you hear about Keiko Hsu and Wings for Women?
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Q.5
What type of major transition are you currently going through?
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Going through divorce
Post-Divorce
Other
Contemplating divorce
Briefly describe your transition and timing.
Q.6
What are your top 2-3 goals you are trying to achieve within the next 1-2 years to improve the quality of your life?
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Q.7
What are the greatest challenges you currently face that are getting in the way of you achieving your goals?
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Q.8
What will be the cost or impact to you if you DON’T address these challenges right now?
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Q.9
On a scale of 1 to 10, how important is it for you to achieve the top goals you described in Question #6? Please give a brief explanation for your answer.
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(1=not important at all, 5=somewhat important, 10=extremely important)
Q.10
In an “ideal world”, describe in a brief paragraph what you want your life-after-divorce to be like.
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