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Coaching Inquiry Form

Welcome, I'm so glad you're here.

If you've spent years being the strong one, the responsible one, the fixer, the caregiver, or the woman who holds everything together while quietly falling apart inside, you're in the right place.

Balanced HER™ Burnout Recovery Coaching was created for women who are tired of surviving and ready to start living with intention, balance, and self-trust.

This coaching experience is designed to help you move beyond burnout, reconnect with yourself, establish sustainable habits, and create a life that feels aligned rather than overwhelming.

Please complete the form below. Once submitted, I'll review your responses and contact you regarding next steps and availability.

You deserve support, too. 🤍

— Yasmilet Garcia, LCSW

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Name (First, Last)  *
Date of Birth (Mo/Da/Yr)  *
MM
/
DD
/
YYYY
Contact Details (Include e-mail, phone, and best way to contact you phone, email, or text)  *
City and State of Residence  *
Preferred Session days and Times (Please make a selection of both days and times as it helps with my current availability)  *
Required
Which of the following best describes your current experience with burnout? (Select all that apply) *
Required
What is the primary outcome you hope to achieve through burnout recovery coaching? *
On a scale of 1 to 5, how urgently are you seeking support to address your current challenges? *
Low urgency (exploring options)
High urgency (need support immediately)
How will you be paying for services  *
Required
Is there anything else you would like to share... *

Coaching Acknowledgment & Consent 

Balanced HER™ Coaching is a coaching service and is not psychotherapy, counseling, mental health treatment, crisis intervention, or a substitute for medical or mental health care. Coaching focuses on personal growth, goal achievement, mindset, confidence, burnout recovery, and accountability.

Participation in coaching does not establish a therapist-client relationship with Yasmilet Garcia, LCSW.

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