BII Discovery Call Application

Hi there fellow BII Sister! I'm very much looking forward to meeting you and strategizing with you. Because I only work with a handful of women at a time, I do have a strict process for selecting the ladies that I agree to work with, which requires some information to get to know a bit more about you before deciding to meet. Should we decide to work together, our partnership will be a two-way street, meaning you will choose me, but I will also choose you. It is important that you are truly ready for this kind of holistic program...it's not for everyone. Please fill out the following questionnaire to help me better determine if we might be a good fit. Thank you!
1. Have you explanted? If yes, when did you explant? Who was your surgeon? If no, are you planning to explant? When? Who is your surgeon?
2. Were/Are they silicone or saline? Ruptured/not ruptured? Any unusual pathology?
3. What are the top 5 symptoms you're struggling with?
4. On a scale from 0-10 how would you rate the overall severity of your symptoms?
5. On a scale from 0-10 how would you rate your level of commitment to restoring your health?
6. On a scale from 0-10 how would you rate your faith that you will be able to restore your health?
7. Is there anything stopping you from restoring your health after explant?
No time
No one to help me
No motivation
No knowledge
No money
There is nothing stopping me; I'm ready!
8. How long do you believe it will take to restore your health after explant?
8. Do you understand that everyone is unique and there may be some course-correction needed along the way during this journey?
Yes
No
9. If we decide to work together are you willing and able to watch online videos I have created for you as we move through this journey?
Yes
No
10. What is your motivation for wanting to restore your health? For example, what is your current condition preventing you from doing/being in life that you would like to change? Please be specific.
11. WHY do you want to work with me?
12. What is your goal?
13. What will reaching this goal mean to you? Please be specific and as detailed as you can.
14. What does optimal health look like to you? Please be specific.
15. What things have you tried so far that have helped?
16. What things have you tried that have NOT helped?
17. What supplements or medications have you been taking?
18. What are you willing to do to change your situation?
Have someone tell me exactly what to do and eat each day
Have someone make sure I stick to a program
Follow a detox program
Make diet and lifestyle changes
Address hidden stressors that might be preventing my healing
Take certain supplements short-term to support the body in detoxing and healing
Be consistent, disciplined, and compliant with my healing plan
Attend/Participate in virtual group coaching calls
Address my mindset and the mental/emotional aspect of healing
Try new things and that might put me outside my comfort zone if it means moving forward in my healing journey
I'm willing to do anything to get my health back
19. If there was an opportunity presented to you that solved your problem, what are you willing to invest in yourself to get to a place where you're living the kind of life you want and deserve to be living? 
$0-500
$500-1000
$1000-5000
I would invest any amount of money if it means getting my life back - my health is priceless
20. Are you the sole financial decision-maker in your household? 
21. What is your occupation?
22. Is your spouse/partner available to be on a Discovery Call with you? I find this very helpful.
23. I consider my time to be valuable. If offered a Discovery Call, do you agree to be available on time for our consultation?
24. How did you hear about me?