Application Form
Thank you for applying! I look forward to learning about you!
Full Name *
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On a scale of 1 -10 how happy are you with your life right now?
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When it comes to your health, which area needs most attention, ( check all that apply).
How open and willing are you to improve your mental and physical wellbeing so you can experience more joy, feel lighter and THRIVE. *
How committed are you to taking action in improving your mental and physical wellbeing?
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Hypnotherapy is different than coaching. How willing are you to apply what you will learn in our sessions and make effort to reinforce things at home. *
Right now I ...
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How bothered would you be if you did NOT take action to better manage your overall wellbeing.
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How willing are you to make simple DOABLE health habits knowing they will help to support your mood, health, work, and family.
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Which statement best describes your view about your commitments to yourself?
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When you’ve formed a healthy habit in the past, what helped you stick to it?
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There is often a connection between financial security, success and health habits. Describe your relationship with your finances?
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There is often a connection between relationship success, communication and your health habits. How would you best describe your personal relationship?
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Which description suits you best?
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Knowing that work and family take up time, are you willing to balance yourself with other things in life to bring you calm and joy?
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The mind and body work together, how much work or have you explored with Mindset?
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Fueling your body with the right nutrition is an essential part of feeling healthy, both mentally and physically. How open are you to nutritional suggestions to ensure you are able to properly manage your blood sugar levels.
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Exercise helps balance stress and elevates mood, not to mention all the other health benefits.
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