Free Life Coaching Consultation

However, you may be interested in our more advanced and comprehensive executive coaching services: executive coaching services

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Dr. Marshall Colt provides a free, phone (or e-mail) consultation to assess and discuss your situation with you.  He will then tell you if and how we may be of service to you.  

Before filling out this form, please see our fees page so you'll know how much our life coaching services cost ahead of time.

If our fees are in line with what you expect to pay for expert life coaching services, please submit the information below. All information is kept strictly confidential.  Please see our Privacy notice

Full Name

Company/Organization  How long?

Position  Stress level

Address

City  State/Province

ZIP/Postal code  Country Afghanistan Albania Algeria Andorra Angola Anguilla Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Azores Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia Hercegovina Botswana Brazil Brit.virgin Is. Brunei Bulgaria Burkina Faso Burundi Cameroon Canada Canary Islands Cape Verde Caroline Islands Cayman Islands Central African Rep Chad Chile China China Peoples Rep Colombia Comoros Island Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Is Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgetown Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guatemala Guinea Guinea Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kampuchea (cambodia) Kazakhstan Kenya Korea Kuwait Kyrgystan Laos Dem Rep Of Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Madagascar Madeira Islands Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mexico Miquelon Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar (burma) Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Norway Oman Sultanate Other Pakistan Palau Panama Papua New Guinea Paraguay Peo. Rep. Of Congo Peru Philippines Pitcairn Islands Poland Portugal Qatar Rep Of Korea Rep. Of Hungary Rep. Of Kiribati Reunion Is. Romania Russia Rwanda Sao Tome Island Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka St Helena St Kitts St Lucia St. Vincent Sudan Suriname Swaziland Sweden Switzerland Syria Tadikstan Taiwan Tanzania Union Rep Of Thailand Togo Tonga Trinidad Tristan Da Cunha Tunisia Turkey Turkmenistan Turks & Caicos Isl Tuvalu Island USA Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City State Venezuela Vietnam Western Samoa Yemen Zaire Zambia Zimbabwe

E-mail(Must be proper e-mail format: xxx@yyy.zzz)

Telephone  
(Include area code, please; or country and city codes, if appropriate)

Facsimile  URL(http://www.xxxxxx.yyy)

Please describe your life coaching needs and specific goals to the extent you feel comfortable (kept confidential):

I prefer to be coached via (please check one):
  Telephone   In Person   Instant Messaging (IM)*  E-mail*
* available only to international clients, please.

How you heard about Dr. Colt or Advance Coaching: Please choose one: Employer referral Friend / Colleague Magazine: (please name on line below) National Association of Working Women Newspaper: (please name on line below)   "The Chicago Tribune"   "The San Diego Business Journal"   "The San Diego Post"   "The San Diego Rocky Mountain News"   "The International Herald-Tribune"   "USA Today"   "The Wall Street Journal"   "The Washington Post" Radio:   KFYI-Phoenix   WGN-Chicago   WOR-New York Search Engine:  (please name it and your search term on line below)   About.com  (please type in your search term on line below)   AOL  (please type in your search term on line below)   Bing  (please type in your search term on line below)   Google  (please type in your search term on line below)   MSN  (please type in your search term on line below)   Yahoo  (please type in your search term on line below) Television:   KABC-TV  Los Angeles   ABC's "Good Morning, America" Yellow Pages

More specifically, please:
(who, which, what, when, where, how, etc.)

ALL fields, except URL, require an entry, please.  Also, your e-mail address must be in the proper format (xxx@xxx.xxx) or you'll have to re-post your information. Please double-check your information before clicking Submit.