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1:1 Wellness program Intake form
You are filling out an application form that will help Erin determine if you are a good fit for her 1:1 Wellness Mentoring Program.

What is included:

–The freedom to create a consistent yoga, meditation, and breath practice
–Engage in a 55 min 1:1 call each week to connect and track forward momentum
–Collaborate and be held accountable
–Together we will evaluate your lifestyle habits
–Facilitate change in your life with access to recorded and live programming

Please fill out the questions below so I can see if we are suited to work together. If so, you will be invited to join a video call where we can determine what is right for you!

*Everything will be kept confidential

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Name *
Email *
Phone Number
Where did you learn about Erin's program?
Do you move your body on a daily basis? What do you do?
Do you consider yourself spiritual and have spiritual practices? What are they?
What is your #1 wellness goal? What is your #2?
Are you ready to dive in, do the work and show up for yourself?
My work is rooted in Yoga, Meditation and Breath work but also focuses on other themes that are woven through our time together. What areas of focus most interest you? (pick multiple) *
Expand on your chosen area of interest above. What are your top interests? What would you like to learn more about or weave together in your day to day?
This program is a 4 figure investment depending on length of our collaboration. Are you willing to make that commitment? There are many payment options available. *
Thank you for your willingness to show up for yourself!
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