Individual Coaching Application

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We want to have a good view of who you are and what you are looking for. None of these questions are qualifiers or disqualifiers. All responses are held in strict confidence.

Email *

What is your name?

Are you currently in a romantic partnership?

Yes

Unclear

Clear selection

If you answered "yes" or "unclear", please tell us more about your relationship(s)

Which one of our individual coaching offerings are you interested in? *

Bloom Her Open! (Coaching for men who want more feminine flow and radiance from their partner)

Man Him Up! (Coaching for women who want more masculine presence from their partner)

Finding My Life Partner

I may have selected the wrong application. I am more interested in couples coaching.

Required

What is attracting you to our individual coaching?

What are the 3 things you’d most like to shift or change as a result of this coaching? *

Please list books, seminars, teachings, training programs and therapies that have significantly impacted your growth. *

Investment in coaching

Coaching requires a significant amount of time, change, practice, and financial commitment. We are willing to invest in a 90 minute coaching session at no charge in order to determine coaching compatibility. What are your resources and availability to make this commitment?

PS: As you will see below, we offer financial assistance to some individuals and couples whom we believe would greatly benefit from our coaching but do not have the financial resources to afford coaching.

PPS: Our livelihood comes from coaching...

I am fully committed and willing to prioritize and invest time and effort in coaching.

yes

Clear selection

I am fully committed and willing to invest financially in coaching. Should you be fully committed and worried you cannot afford our full fees, please rate this as a 5 and give us details regarding your need for financial assistance in next question.

yes

Clear selection

Should you need financial assistance, please let us know your current situation and enroll us into offering you financial support.

Have you been under the care of a therapist or mental health professional? If yes, please share the nature of care. (We encourage our clients to continue therapy in parallel to coaching. This is not a discriminatory question).

Is there anything else that may be important for us to know about you?

Last but not least, how did you hear about us?

A copy of your responses will be emailed to the address you provided.

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