Career Glow-Up Intake

📋 Personal Information

Full Name *

Email Address *

Phone Number *

Preferred Contact Method *

📧 Email

💬 Text

📞 Phone Call

What excites you most about starting a healthcare career? *

🤝 Helping patients hands-on ⚖️ Balancing clinical + admin tasks 🏢 Working in a structured office setting 🤔 Not sure yet — I need clarity

Which career path are you MOST interested in right now? *

👩‍⚕️ Certified Nursing Assistant (CNA) 🩺 Medical Assistant (MA) 💼 Medical Office Assistant (MOA) 🤷‍♀️ Still deciding

What's your #1 career goal in the next 6–12 months? *

🏆 Get certified & start working 🎓 Go back to school later (RN, LPN, etc.) 🔄 Transition from my current job into healthcare

📝 Other:

What's been holding you back from starting sooner? *

💰 Finances 😰 Fear/doubt 🤯 Confusion about the right path ⏰ Time/schedule

📝 Other:

On a scale of 1–5, how ready are you to begin your glow-up career journey? *

1 – Just exploring 2 – Curious but not ready yet 3 – Ready within a few months 4 – Ready soon 5 – I'm ready NOW!

Which would you like to do after completing your Clarity Session? *

📅 Schedule a class now ✨ Book a Career Glow-Up Session first 🤷‍♀️ I'm not sure — I need guidance