High Performance Coaching for Women with ADHD/Symptoms - Yellow Parachute Learning Partners

Book your Let's Get to Know Each Other with Cara Thorpe now.

Duration: 45 minutes
Date:
Time:
Continue
Name: *
Email: *
Cell Phone:
Street Address:
City:
State:
ZIP Code:
Please take a moment to evaluate where you are in these following items...

Remember to apply the following rule of thumb:
5 is I'm doing awesome here, couldn't ask for more!
4 is I'm doing great, no complaints!
3 is I'm doing okay, though could be better
2 is I'm kinda rough or lacking this area
1 is a straight up problem
0 is gah, total failure!


Area of Life
Score (past week)
Family/ Relationships {"type":"radio","name":"family","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on family","options":"0\n1\n2\n3\n4\n5"}

Friends/Relationships {"type":"radio","name":"fitness","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on fitness","options":"0\n1\n2\n3\n4\n5"}

Sleep {"type":"radio","name":"fitness2","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on fitness","options":"0\n1\n2\n3\n4\n5"}

School {"type":"radio","name":"work","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on work","options":"0\n1\n2\n3\n4\n5"}

After School (Activities)  {"type":"radio","name":"work2","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on work","options":"0\n1\n2\n3\n4\n5"}

ADHD/EF Skills Symptoms (coping) {"type":"radio","name":"prosperity","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Routines Serving YOU {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Mental Health {"type":"radio","name":"purpose2","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Physical Health {"type":"radio","name":"purpose3","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Spiritual Health {"type":"radio","name":"purpose4","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Totals/Average:  
 {"type":"computed","name":"totalScore","width":20,"value":"","size":"Normal","validation":null,"validationMessage":null,"formula":"family+fitness+work+prosperity+purpose","hidden":false}

 or  {"type":"computed","name":"percentageAwesome","width":20,"value":"","size":"Jumbo","validation":null,"validationMessage":null,"formula":"(totalScore/25)*100","hidden":false}

 % of awesome


Comments:
{"type":"textarea","name":"overallComments","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":170,"placeholder":"Optional, but hopefully you have some sentiments to share for the record!"}



Thanks for taking the time!  Be sure to mark it complete.

Almost done! Please enter your payment information to complete your purchase.

You will be billed immediately $1,000.00.

Name on Card:
Card Number:
CVV:
Expiration Date:
ZIP Code: