1:1 Coaching Application with Dr. Rae 

I’m so excited to get to know you on a deeper level! These questions help me learn more about you beforehand, allowing me to customize our session to your unique needs and maximize our time together—a true win-win!

✨ For fertility or pregnancy services: Each partner should submit their own application separately. This ensures I can provide the best support for both of you. Please don’t fill it out on behalf of your partner, as it makes it trickier for me to tailor my guidance effectively. Thank you!

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Email *
Full Name? *
Phone Number *
What is your profession or passion? *
Why are you reaching out to me? What challenges, struggles, or concerns are you currently facing?   *
What are you interested in at this time? (Check all that apply) *
Required
What are you currently doing to solve your problem? What is working? *
What isn't working to solve your problem? *
How long have you been working on solving these concerns? *
What obstacles have you encountered along the way? *
What to do you feel is holding you back from solving your concern? *
What is your number one goal to come out of solving this issue? Why is it important to you? *
Have you worked with any healthcare or wellness professionals before? (e.g., Midwife, OB-GYN, Fertility Expert, Endocrinologist, Reproductive Physiologist, Health Coach, etc.).  If so, how was your experience? (If you’ve worked with multiple providers, feel free to share a short blurb about each.) *
What type of learner are you? (Please pick only your TOP choice if possible) *
Required
How can I best accommodate you during our session? (Check any that apply) *
Required
What makes us a good match to work together? Why work with me instead of someone else? What are you looking to gain/learn from our partnership? *
How important is solving this challenge for you right now? *
Not important
The most important thing in my life right now
Do you have the financial resources available to invest in yourself or your family? *
What is the most important thing you want to make sure we discuss during our session? *
Is there anything else you’d like me to know? *
How did you find/hear about me? (Reel/post, referral, IG Explore page, podcast, etc.) *
What is your IG handle (or profile link for the SM platform you use most)? *
  Thank you so much for taking the time to fill out this application! You are an amazing soul, and I can’t wait to learn more about you and your journey. I’ll be in touch in the next 48 hours—let’s make something beautiful happen together!  
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