Date *

First Name & Last *

Email *

Phone Number *

City, State or Country of Residence *

Tell me your epic dream, your juicy vision, for yourself and your life. Don't censor yourself. *

Do you have a BIG vision to utilize your sacred gifts and creativity? If so, what is it? *

Why do you feel that we would be a good match for this work together? *

What is your current relationship to your body? *

To your Sexuality? Your Pleasure? *

To your Divine Feminine? To your Inner Goddess? *

Do you have any hormonal symptoms? *

What is your biggest challenge currently? *

How long have you struggled with this? *

Have you ever worked with a coach? *

Have you worked with a Yoni Egg before?

What do you feel needs to be cleared from your sacred womb? *

What would you like to achieve through this program? *

This program is a Transformational Investment that helps you make BIG changes on your life's most challenging patterns starting at $2197 (for Personal Transformation) and $3197 ( for Certification), with payment plan options (9 month payment plan option ends May 28th). Do you have or are you willing to find the financial means you need to invest in this program? *

Are you ready to commit to 6 months (12 modules) of goddess group coaching to activate your Shakti Divine Feminine energy for healing & manifestation of your visions, and to fully turn on your Radiant Juicy Self? (Will you MAKE and Devote the TIME to carve out and devote to self-care practices that are in this course?) *

Do you have any final thoughts or questions that you'd like to share with me as I consider your application? *