Kim Halsey Change Agent
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YOUR CART
STAGES OF CHANGE
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Indicates required field
Choose One
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Replicating (18-25) Living the life you learned
Rewarding (26-35) Living the life you earned
Rethinking (36-50) Living the life you want
Reinventing (51-70) Living the life of your dreams
Recalibrating (71 +) Living your life without regret
How do you spend your time?
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Employed (FT or PT)
Entrepreneur
Retired
Unemployed
Where do/did you experience the greatest success?
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Career & Finance
Health & Wellness
Relationships
Personal Growth
Spiritual Growth
What area holds your deepest desires?
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Career & Finance
Health & Wellness
Relationships
Personal Growth
Spiritual Growth
I want for nothing
Any regrets?
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Career & Finance
Health & Wellness
Relationships
Personal Growth
Spiritual Growth
None
How many times have you tried to fix something in your life?
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Never
1-5
6-10
11-20
Too many to count
Where did you go for help?
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Family or Friends
Online Support
Individual Counseling
Group Support
All of the above
Within - I can do this myself
How is it now?
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Much Better
Somewhat Better
About the Same
Somewhat Worse
Much Worse
Would you like to talk confidentially about it?
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Yes
Maybe
You're kidding, right?
If you give contact information below, we will reach out to see how we might help
Name
*
First
Last
Email
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Phone Number
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