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Teen & Family Assessment

Thank you for taking this step. This application helps me understand your teen, your family, and whether this mentorship is the right fit. I review every submission personally, and I only work with a handful of families at a time to ensure each teen receives the attention and guidance they deserve.  This assessment takes just a few minutes.

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Section 1 ~ Teen & Family Info

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Question 2 of 16

Please fill out the following information:

 

  1. 1.Parent Name(s): 

  1. 2.Phone Number: 

  1. 3.Teen’s Name & Age: 

  1. 4.Location (City, State): 

Section 2: Your Teen's Current Situation

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Question 4 of 16

What are the top 2–3 challenges your teen is currently facing?

Question 5 of 16

Have they received any previous support (therapy, coaching, treatment)?

Question 6 of 16

How would you describe your teen’s openness to guidance or mentorship right now?

A

Very Open and Motivated

B

Somewhat Open, Willing to Try

C

Resistant but Curious

D

Unsure

Section 3: Goals & Motivation

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Question 8 of 16

What would success look like for your teen and your family after six months of mentorship?

Question 9 of 16

Why is now the right time to engage in this mentorship?

Section 4: Commitment & Fit

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Question 11 of 16

Are you able to commit to the full six-month program, including biweekly calls with your teen and monthly strategy sessions with parents?

A

Yes

B

No

Question 12 of 16

As parents, what role do you hope to play in supporting your teen through this process?

Section 5: Financial Readiness

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Question 14 of 16

This mentorship is a significant investment in your teen’s growth and transformation. Are you in a position to make this commitment at this time?

A

Yes

B

No

C

Unsure

Section 6: Additional Context

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Question 16 of 16

Is there anything else you’d like me to know about your teen or your family that would help me understand your situation?

Confirm and Submit