Optimal Life Design Application
WELCOME, health enthusiast!

*** PLEASE READ ***

I'm so excited you're interested in re-designing your life in a way that supports a healthier and happier version of you. While this application process might be illuminating for you, I want you to know that you are under no obligation to join the program upon completing this.

I'd appreciate if you could answer the following questions with an open heart. There are no right or wrong answers. It should take about 10 minutes of your time depending on the depth of your responses.

Shortly after submitting your application, we will be in touch with you to outline next steps.

PLEASE NOTE:
* Everything you share here is private and confidential. Please feel free to share your truth.

Looking forward to learning more about you!

In optimal health,
Dr. Rhea Mehta

Email address
Name
Your answer
Email
Your answer
Phone or Skype ID
Your answer
Where do you live? (State/Province, Country) This will help us with time zone coordination!
Your answer
Getting to know YOU
Why are you feeling called to being supported in self-discovery, ritual & routine, detoxification and nutrition in your life right now?
Your answer
What does your current self-care routine look like? Note: your self-care routine can be as simple as doing your bed every morning or brushing your teeth and as hardcore as working out 7x week and fasting 1x week.
Your answer
What is getting in the way of your health desires and goals?
Your answer
Your current health scorecard
Rate your reactions to each pair of phrases by deciding where you lie on the scale.
I have set health goals for myself
Completely Untrue
Completely True
I have the energy I need to carry out my day
Completely Untrue
Completely True
I have the accountability and support I need to make healthy changes (family, spouse, colleagues, friends)
Completely Untrue
Completely True
My diet is healthy
Completely Untrue
Completely True
I recognize and celebrate my baby steps, rather than being hard on myself
Completely Untrue
Completely True
With more energy and clarity, how could your life transform? Consider goals, passion projects and relationships you've pushed aside because of lack of motivation and/or energy. Be as specific as you'd like!
Your answer
Investment
This program is designed to be a powerful investment in you. An investment in you is an investment in your work, your message, your life, your heart, and your most valuable relationships. As such, we want to support you in discovering if this feels right for you!

The Optimal Life Design program will dive deep into the following topics:

1) Self-discovery: core values, intention-rooted visioning, body awareness, meditation (external expert support)

2) Ritual & Routine: opening and closing ceremonies, self-care tracker setup, mind coding, body relationship practice (external expert support)

3) Detoxification: identification of triggers, product replacement guide, detox strategy with laser coaching, detox yoga (external expert support)

4) Nutrition: eating techniques and myths, supplements and hacks for energy, functional food & drink recipes, shopping list & meal plan, conscious meal meditation

Each week of the program will include:
- Live video group coaching sessions facilitated by me
- Partner accountability support (you’ll switch partners every week)
- Love work (ie home work!) in between sessions
- Private social channel for daily communication, q&a, accountability and support

The cost of this 6-week program is $997.

Please note that if it's fully aligned for you to join, I will help you get there and there may be other payment options or energy exchanges available.

I am happy to talk through this investment with you.
Which session of the program would you like to be in? (Select your first preference)
Is there anything else you'd like me to know? Do you have questions? Something specific about your health history? This is the time to share!
Your answer
Application Acknowledgement
I’ve completed the Optimal Life Design application and would like to be considered. I understand I am only showing interest in the program and am under no obligation to join or make payment.

I understand that if it is determined that the program and I appear to be a good fit, I will be invited to have a conversation with Dr. Rhea where I can ask clarifying questions.

If I am accepted and willing to join, I am committed to doing everything in my power to get the most from this program, including supporting the other members' by acting as a cheerleader.

Acknowledgement
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