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GOE Within Transformational Life Mentoring Questionnaire

Hello Beautiful Soul,

This questionnaire is an intentional first step in returning to your Garden of Eden Within, the place where identity, spiritual depth, insight, and alignment meet.

When you GOE Within, the transformation taking place internally begins to shape the life you lead externally. Your leadership, your relationships, your work, and the legacy you are building, begin to reflect that inner alignment.

My mentorship and coaching work is designed for high-capacity leaders, individuals who already carry influence, responsibility, and the aptitude to create meaningful impact in their families, communities, and professional lives.

This work is for those who practice transparency with themselves, deepen their insight, and take courageous responsibility for the lives they are creating.

This is not a space for quick fixes or surface-level change. It is a space for individuals who are willing to engage the deeper work of reflection, alignment, and intentional action between sessions.

The individuals I journey with are often creators, founders, entrepreneurs, professionals, visionaries, and spiritually attuned leaders who feel called to ensure that their inner life matches the legacy they are building outwardly.

If you are ready to:

• deepen alignment between your identity, values, leadership, and purpose
• refine the way your inner life shapes your outer life
• build a legacy rooted in purpose, courage, and spiritual depth
• engage in collaborative work that calls you higher

…this mentorship container may be the right next step.

Once submitted, please email goewithin@gmail.com to confirm your submission. Thereafter, I will follow up with next steps.

Please Note:

GOE Within operates as a cash-pay mentorship and coaching service. These offerings are not therapy and do not involve insurance billing or clinical treatment. Mentoring and coaching are available to individuals across state lines and internationally.

With reverence for your journey,
Jéssica Cohen
Transformational Life Mentor 
Founder & CEO of GOE Within
Email *
Date
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First Name *
Last Name
Phone Number *
The city, state, and country I reside in, is: *
My occupation is: *
My annual income is: *
My monthly income is: *
I found you through: *
What are you looking to transform in your life right now? *
What does a successful transformational mentoring journey look like for you? How would you know this container created real change? *
What feels most out of alignment in your life today, and what do you feel called to shift? *
What patterns, habits, and beliefs are you ready to release? *
Are you prepared to commit to inner work between sessions (reflection, journaling, embodiment practices, accountability)? Why or why not? *
What level of support do you feel you need right now? *
Required
Have you received any personal support, guidance, or healing services in the past?

If yes, please share:

1) The type(s) of support you’ve received (e.g., therapy, coaching, mentorship, spiritual guidance, support groups, etc.)

2) What specifically felt helpful or unhelpful about the experience?

3) What did you wish was different, deeper, or more aligned?

 *
How willing are you to work through your greatest barrier, fear, and shame to reach your desired transformation? *
Not willing at all
Extremely Willing
What is your greatest desire? *
What do you view as your greatest barrier to transformation? *
What is your greatest fear? *
Are you currently experiencing a mental health crisis (suicidal ideation, self-harm, or inability to complete daily functioning)? *
Are you seeking mentorship as a replacement for therapy or clinical treatment? *
Are you currently in therapy or receiving other support services? If yes, please share briefly to ensure there is no overlap in roles. *
Do you understand that mentorship cannot diagnose, treat, or manage mental health disorders? *
Are there any safety concerns in your life right now that would affect your ability to engage in coaching? *
This mentorship space is fully virtual. Are you willing and able to attend sessions from a quiet, stationary, and confidential location? Sessions cannot be held while actively driving or in environments where surrounding noise prevents clear communication. *
Are you able to commit to attending sessions on time and engaging actively for the full length of the container? *
What values guide you right now, and how would you like those values to guide you more intentionally? *
What are you tolerating right now that you wish to stop? Why do you believe you tolerate it? *
Why do you feel called to GOE Within at this moment in your life? *
What is the most frustrating about your challenge? *
What are you most ashamed of? *
If money were unlimited, what would you spend your life doing or being? *
What’s stopping you from living that now? *
In one sentence: Why do you feel this container is aligned for you? *
Is there anything else you want me to know as I consider your application? *
A copy of your responses will be emailed to the address you provided.
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