Discipline Series

Which course are you applying for?*

Health
Wealth
Wisdom
Life Is A Business - 12 month Course

Would you be willing to stay onsite at one of our facilities, if it is required?*

Yes
No

You may be required to complete sessions with a trainer, nutritionist, psychologist, and or any other professional that Dr. Sangani suggests for your program? Is this something you can and are willing to do?*

Yes
No

Do you have health issues that could be greatly benefited by this program? If yes, pease explain*

Yes
No

Health issue*

Do you consider yourself to be a psychologically sophisticated person?*

Yes
No

Do you consume recreational substances such as Caffeine, Cannabis or alcohol?*

Yes
No

Please describe*

Are you experiencing tension or unhappiness in your professional or personal relationships?*

Yes
No

Do you find that you make the same mistakes in handling people that are important to you in personal or professional life?*

Yes
No

Please describe*

Do you take excessive risks in business matters and personal relationships?*

Yes
No

What is your risk tolerance like?*

Do you experience sleep disturbance, irritability or ongoing sadness?*

Yes
No

Do you suffer from a tendency to procrastinate or avoid unpleasant tasks?

Yes
No

Do you find that there is a disconnect between what makes you happy and what you do? (you are aware of obvious behaviors that are opposite of what they need to be in order to accomplish your goals?)*

Yes
No

Do people who are important in your life view you in a way that you don't like? (You may think that you are paying attention to them and they don't feel that way. They may think you are rude when they don't feel that way)*

Yes
No

Please describe*

Do you have "stuff from the past" that keeps you from being effective and successful*

Yes
No

Please describe*

What are your concerns in the area of Wealth?*

Are you unhappy in any personal or professional relationship?*

Do you desire to have a healthy personal or professional relationship with someone in particular?*

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