1:1 Coaching Application
Hello Cyster !!

So excited you are here!

I'd like to get to know you better! Please fill out this form so I can know who you are and for us to get deeper into your mind so we can grow together.

This information will help me to cater better to your need and make it a more productive experience for both!

Please be as specific as possible to provide me with the most accurate understanding of your goals, concerns, and desired transformation.

Thank you,

Email address *
First Name *
Last Name *
When is your birthday? *
Copy and Paste the link for your Instagram or Facebook. *
Please tell me a little about yourself (and Partner if applicable)? *
What are you currently struggling with most when it comes to your PCOS? Please provide details such as what has worked for you in the past? What has not worked? and Where exactly are you stuck? *
Why is NOW the time you are ready to commit to this lifestyle change and work with a Hormone coach to meet your goals? What has changed? *
What’s your favorite food? *
What is your MYERS BRIGGS personality type? (link for the test in the email) * *
What do you hope to achieve with PCOS Hormone Blueprint? *
In the next 90 days, what's your biggest goal? *
What are you most excited about in the PCOS Hormone Blueprint? *
What are you most nervous about? *
In what way are you your own worst enemy? How do you self-sabotage? *
What has been the most pivotal point in your life? *
What's something you're really proud of yourself for? (personal achievement?) *
How would your best friend describe you in a sentence? *
How would you describe your best friend? *
What's the BEST piece of advice you've ever received? *
What's the biggest mistake you've ever made? (Professionally or Personal) *
And what's the biggest mindset shift you feel you need in order to surpass where you are currently? *
What motivates you the most? *
How satisfied are you with the relationships you have and the people you surround yourself with? *
Not Satisfied
Very Satisfied
How can you get this closer to a 10? *
How satisfied are you with the contribution and value that you give society and those around you? *
Not Satisfied
Very Satisfied
How can you get closer to a 10? *
How well do you feel you are (1) acting like your true self VS (10) pretending to be someone you're not? *
How can you get closer to a 1?
On a scale of 1 to 10, how do you feel regarding your current state of personal development? *
Do I have your permission to hold you accountable to your highest self, and let you know when we see your limiting & self-sabotaging patterns getting in the way? *
Do we have your permission to be totally & completely HONEST with you, even if it doesn't feel good? *
Anything else I should know? *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy