Hello! Thank you for being here, I honor you and your journey. Please fill out this form to express your interest in working together one-on-one on becoming your best version.
Email address *
Phone Number (with country code). *
First and Last name *
Age *
Gender *
Relationship status *
Location (City, State / Country) *
Your desires in coaching
What are your biggest struggles or challenges you are currently facing your life situation, personally and/or professionally that you know you want to work on? *
What are 1-3 things that you are currently working on or have worked on in the past? *
What are the three things you most want from our work together? *
Do you have any previous experience with therapy, personal development, coaching, meditation, etc? If so, tell me a little about those experiences. What did you learn about yourself? What were your biggest insights? *
On a scale of 1-10 how ready are you to commit to yourself, your growth and your life and show-up fully to coaching? *
Not ready at all
More than ready
Health History
Have you ever been diagnosed or treated for a serious psychological or mental health issue? *
Are you ready to invest in coaching? *
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