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Please complete the short form below. Your answers will help determine whether there’s strong alignment for a high-trust, high-impact engagement. All submissions are treated with confidentiality and care.

First Name

Last Name

Email Address

Phone Number

Time Zone/Location

Leadership & Business Context

What is your role?

Briefly describe your organisation or venture, including its scale, scope, impact, and context

What is the biggest challenge you’re currently navigating in your leadership or life?

What would meaningful transformation look like for you over the next 12 months?

What will happen if you don’t take action and make a change now?

Why are you considering working with Damien / Quantum Connection at this time?

Investment & Fit

Have you previously worked with a coach, guide, advisor, or mentor?

Are you open to making a significant financial investment in long-term strategic coaching or advisory support—on behalf of yourself, your company, and the people you serve and impact?

How did you hear about Damien or Quantum Connection?

Final Insight

Is there anything else you’d like Damien to know?

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Your form will be personally reviewed. If there’s clear alignment, you’ll be invited to a confidential 30-minute exploratory call. Damien works with a small number of high-trust clients each year, so availability is limited.

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