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Please fill out this short form below to see if you qualify for a discovery call for one of Starr Burgess' premium breakthrough programs.

First Name *

Last Name *

Email *

Phone *

What career or business are you in? *

What areas of life do you feel you are a high achiever? *

Career/Business

Body/Health

Relationships

What areas do you feel you want improvement in? *

Do you value high level consulting/coaching? *

Yes, of course. I've invested in self-development and improving myself throughout my life and career.

I'm not sure if I need it, but I'm interested.

No, not sure why I'm here.

If Starr could help you create massive breakthrough in one area of your life for the next 8-Weeks- which area would you value the most? *

Self Care/Self Love- I don't create enough time for my own wants and needs

Boundaries- I have a hard time saying no and feel overwhelmed.

Relationship Habits for when I come home to create a better relationship with myself and my loved ones.

All of the above

Who are the decision makers to decide how much money to invest? (if it's another person that also helps you make a decision- please make sure they are on the call or you already have their approval to invest in the amount that you checked above) *

Myself and I'm ready to make a decision if it's the right fit.

Me and another business partner

Me and a domestic partner

Are you committed to investing your time and money into this personal transformation if we both decide it's a good fit after our discovery call? *

Yes, I am committed and ready to invest my time, money and attention.

I am not sure, I need to see if we vibe first.

I do not have any cash or time to invest.

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