Coaching Request

Let’s Get Started

Step 1: Fill in this form
Step 2: We’ll get in touch, discuss pricing and a suitable time
Step 3: Start your coaching with Barbara

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First Name*

Last Name*

Mobile Number

Email*

State*

Address*

Where did you hear about us?

Have you read anya Allan & Barbara Pease books (please list all).

Why have you decided to engage Barbara Pease for coaching?

Briefly describe the problem you would like help with.

What is your #1 personal goal?

What do you want more of in your life?

What do you want less of in your life?

What are your top 5 – 7 questions for Barbara?

Is there any other background information about you that you’d like Barbara to know before your call?

Area of interest

Goals/ personal development

Communication/ body language

Other (please detail)

What is your preferred day/time for your session?

Mon/ Tues 10am – 10.30am

Wed/ Thur 12pm – 12.30pm

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Matt W

“There are so many lessons to be learned. I achieved what I wanted to – Barbara is absolutely
amazing.”

Julia S

“It was such a charging, teaching session! I admire you, you are so open and sincere. Thank you.”