Survey Questions for Holistic Emotional Makeover Empowerment Consultation

Welcome $FIRSTNAME$,

I am pleased to offer you a no-cost Empowerment Consultation. I take the Empowerment Consultation seriously as I want to be sure you are getting the greatest value from our time together. Time is one of our most valuable commodities, yours and mine, let's make the most of it! 

During the Empowerment Consultation we will talk about your challenges and what you think is holding you back from having what you want and a life you love. You will also get clarity on what is in important to you and why and how you want your life to look and feel in the next 4 - 6 months. This time is also very important to make sure we are a good fit to work together.

To make sure our time together is most beneficial, please complete the following Survey Questions.

Please answer the questions as authentically as possible. All information is strictly confidential!

I look forward to connecting with you.

Best wishes and blessings,


The Life Makeover Expert

Remove Every Block to Success for a Life You'll Love!


1. Below is a list of areas that you may want to improve. Check the ones that apply to you.

2. Provide your biggest challenge. (Example: My biggest challenge is  emotional eating and being overweight).

3. What is your 2nd biggest challenge?

4. What is your 3rd biggest challenge?

5. What is your 4th biggest challenge?

6. What is your 5th biggest challenge?

12. On a scale from 1 - 10 (1 being low and 10 being 10) How willing and  committed are you in having the challenges that you listed resolved and having what you want?  

13. The HEM System is a unique premium transformation program.  Are you ready able and willing to invest in the HEM program without financial distress if you feel you and Kathleen are a good fit?