Thank you for your interest in working with Dr. Eric, however his schedule is currently full and there are no openings at this time.
Dr. Eric's Client list ranges from captains of industry, prominent members of the entertainment biz, to successful authors. Already successful people looking to deepen the meaning in their lives.
Dr. E takes his investment in his clients very seriously and only works with a small handful of people on an individual basis at a time.
For those who are serious about working with him, and want to be placed on our waiting list, please complete the client application form.
Step 1: Fill in the application below.
Step 2: You will be notified as soon as possible as to whether your application has been accepted. Fit in any helping relationship is crucial to that relationships success
Step 3: You will be notified as soon as their is space in Dr. Eric's schedule
Step 4: Brenda (Dr. Eric's Biz manager, will send you the information about payment
Step 5: Your Appointments with Dr. Eric will be scheduled and you will begin the process
What you get: Two1 hour sessions per month Email support weekly progress report
Your investment: $1500.00 every 30 days from when you start
Your commitment: A minimum of 3 months
Your results: Your responsibility
If you don't feel you need 1 on 1 at this time and would still like to work with Dr. Eric and think that working with him in a group context might be right for you then pick from the following options;
1. Group life coaching 2. Group dating and relationship coaching 3. Group Small Biz and solopreneurship coaching
Small groups meet 2 x per month at an investment of 100.00 per month
Client Application Form
Please fill out this form. Once completed a copy will be sent to me and to you. Thank you!
Your Full Name
Full Mailing Address
Phone #
Email
Birthday
Referred By
Relationship Status
YesNo
Spouse/Partner Name
What are the three biggest changes you want to make in the next 3 months?
What are the 3 biggest changes you want to make over the next 3 years?
What are you most wanting to achieve? And are you ready for it?
What would you say have been your 3 greatest accomplishments to date?
What is the hardest thing in your life that you have had to overcome?
Who are or have been your major role models and why?
Have you ever worked with a coach before or a similar one-to-one adult relationship? If yes, what worked well for you and what did not work in the relationship(s)?
What major transitions have you had in the past two years? Entering or approaching a new decade, a new relationship, a new career, a new role, a new residence, chang in children's ages/stages, etc?
What improvements would you like to make in your family /home life?
What improvements would you like to make in your financial situation
What improvements would you like to make in your practice and professional life?
What improvements would you like to make in your personal character?
What improvements would you like to make in your relationships
What improvements would you like to make in your leisure time?
What improvements would you like to make in your self-care?
What improvements would you like to make in your learning?
Who are the key people in your life and what do they provide for you? Do you have a mentor?
Is you life one of your choosing? If not, which parts are being chosen for you?
YesNo
What is your favorite part of your typical day?
What is your least favorite part of your typical day?
Looking at the past six months of your life, do you like the direction your life is moving in?
YesNo
On a scale of 1 to 5, 5 high, rate the amount of stress in your life right now
Less True - 1 2 3 4 5 - More True
What are your primary stressors?
List five things that you are tolerating or putting up with in your life at present. (examples: staff who don’t take initiative, non-cooperative peers, poor management, information you can’t find, corporate politics, job dissatisfaction, career plateau, etc.)
List five adjectives that describe you at your best.
List five adjectives that describe you at your worst.
What are your 3 major concerns/fears about yourself?
What are your 3 major concerns/fears about life?
What motivates you?
What are you learning/accepting about yourself at present?
What would you like me to do if you get behind on your goals?
Do you understand that you are 100% responsible for your own results?
YesNo
Are you committed to taking new actions to improve yourself, your life and your practice?
YesNo
Do you understand that you are free to use what works for you and leave the rest?
YesNo
How will you know when you are receiving value (i.e your money's worth?)
What types of approaches discourage you or take away your motivation?
In what way might your internal saboteur show up in our work together that i should be aware of ?
Do you enjoy self-assessments and improvement programs?
YesNo
Do you like brainstorming strategies?
YesNo
Do you like support, encouragement and validation?
YesNo
Do you like insight into who you are and your potential?
YesNo
Do you like painting a vision of what you can become or accomplish?
YesNo
Do you like exploring and removing blocks and obstacles to your success?
YesNo
Does accountability; checking up on goals work for you?
YesNo
Do you like working through self improvement programs together?
Do you want to design action steps?
Do you have a personal or professional vision? if so what is it?
What would you like to contribute to the world?
What do you think is NOT possible to achieve in your lifetime that you wish you could?
What is a dream or goal you have given up on?
What part of yourself, if any, have you given up on?
On a scale of 1-5 with 5 high, rate the quality of your life today.
Less True - 1 2 3 4 5 - More True
If you reach the age of 95 and continue to live you life and order your time the way you are right now, what regrets do you think you will have? (tip: complete the statement 'I wish i had...' Do not include things from the past-only thing you will regret if you continue your exact present path.
This application does not imply in any way that we will be working together. It only means that when there is an opening we will begin a dialog about potentially working together.
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