Fun.Da.Men.Tal Detox Program Form
In-depth, at-home detox cleanse for public figures, executives and high achieving individuals.

Thanks for reaching out! We value your request and look forward to getting back to you in a timely fashion. Please take a moment to fill out this form to provide additional details about your needs. Jovanka currently has a 2-month waiting list for Fun.Da.Men.Tal clients. That being said, we would love to hear more about your goals and someone from our team will be in contact with you within the next 1-3 business days.

Email address *
Your Name *
Your answer
Employer / Organization Name *
Your answer
What are your top health / wellbeing goals? *
Your answer
What are your top lifestyle goals? *
Your answer
How much time to you have to dedicate to your own health and wellness goals? *
What is your salary range? *
Why do you feel that you need a detox now? *
Your answer
Have you ever worked with a coach? If so, what was the experience like? *
Your answer
What results do you expect to see from the work we do together? *
Your answer
What’s keeping you from overcoming or meeting your challenges? *
Your answer
How would you like to feel once you overcome that challenge? *
Your answer
What problems do you see down the road that could obstruct or constrain our working together? *
Your answer
What problems do you see down the road that could obstruct or constrain our working together? *
Your answer
If Coach Jovanka delivers on the agreed upon goals, what’s that worth to you? *
Your answer
Addition Information
If you wish to elaborate on your above answers and/or provide any additional information, please do so here.
Your answer
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