Homeopathic Fertility Programme Application
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Email *
Section 1 - About You
What's Your Full Name *
What's Your Partner's Name *
Phone Number *
Where do you live? *
How did you hear about Natasha? *
Section 2 - Your Fertility Journey
How long have you been trying to conceive? *
Have you conceived before? *
What do you feel might be getting in the way of conceiving?   *
What led you to apply for support right now? *
What symptoms or cycle patterns have you noticed that feel “off” to you?
(Examples: irregular periods, PMS, fatigue, gut health, stress, ovulation confusion)   *
Have you had any fertility-related investigations or tests? *
Section 3 — Your Partner’s Health & Support
Is your partner open to being involved in the programme?   *
Anything you’d like to share about your partner’s health or stress levels?   *
Section 4 — Your Current Challenges
What feels hardest about your fertility journey right now?   *
How is your fertility journey affecting your day-to-day wellbeing (emotionally, mentally, or physically)?   *
Section 5 — Readiness & Commitment
Are you able to commit to a 6-month, 1:1 programme that supports both of you?   *
The investment for this programme is £2,500. Are you prepared for this investment in your fertility and health? *
If accepted, how soon would you like to begin?   *
Section 6 — Anything Else? 
Is there anything else you’d like Natasha to know before your assessment call? *
A copy of your responses will be emailed to the address you provided.
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