Welcome,

I’m so glad you’re here.

This questionnaire is a gentle invitation to share what feels true for you right now. There’s no rush, no pressure, and no need to explain more than feels safe. Your words, no matter how brief, can hold deep insight.

If you’re unsure, I often say: “Trust the first thing that comes to mind.”

When you’re ready, feel free to submit. I’ll read every word with care and shape a supportive plan for our time together.

I look forward to connecting soon,
Claire

Personalised Coaching with Claire Chancellor

Name *

First

Last

Email *

Mobile Number *

How did you first hear about me? *

Are we in different time zones? I am currently in Melbourne. May I ask where you are located?

What is your current occupation? *

What’s the Challenge You’re Ready to Release?

What’s the core challenge you’re facing right now? *

How long have you been navigating this? *

How is this challenge showing up in your life... emotionally, in your relationships, or even financially? *

Are you currently dealing with any ongoing health or mental health challenges? *

I ask because the body is always communicating with us. Health challenges often carry valuable clues ...revealing emotional patterns or limiting beliefs that may be quietly shaping different areas of your life.

On reflection, is there anything you would have done differently, in the last 5 years? *

Do you have a history of recreational drug and/or alcohol use? And how is that relationship currently? *

I have zero judgment. I ask this because some processes are not suitable for individuals who recreationally use.

What POSITIVE things would my friends or family say about me as a person? *

What NEGATIVE things would my friends or family say about me as a person? *

If you had a magic wand, what solution would you wake up to tomorrow? *

What Kind of Approach Feels Safe Right Now?

In our coaching partnership, how would you like me to communicate to you? *

How would you describe your level of comfort and familiarity with your spiritual awareness?

Very comfortable
Somewhat comfortable
Not very comfortable

Honouring the Exchange: Time, Energy, and Money

On a scale of 1 to 10 (10 being "Absolutely, ready and willing"), how committed are you to achieve your desired outcome? *

Put in a value between 1 and 10

"I affirm that I have the financial means to invest in my personal development and growth" *

I affirm
I decline

This work is deep, transformative, and designed to meet you where you are. I offer a $250 introductory session so you can get a feel for the process.

Your responses help me shape a personalised plan, so you come away from our first 90-minute session with a meaningful breakthrough. From the start, we’ll focus on creating the impact you want ...not surface-level change.

My clients didn’t choose the stress they’re navigating, but they choose to respond with intention. Coaching helps them shift patterns, reclaim energy, and create meaningful change. The investment pays for itself in how quickly life begins to turn around.

When you're ready to deepen the work, I offer ongoing coaching to support your transformation. We’ll shape the experience around what feels most aligned for you.

Would you like to leave a message for Claire? *

Website

Welcome,

Personalised Coaching with Claire Chancellor

What’s the Challenge You’re Ready to Release?

What Kind of Approach Feels Safe Right Now?

Honouring the Exchange: Time, Energy, and Money

Thank you.Claire will review your information and get back to you

Thank you.
Claire will review your information and get back to you