1:1 Health & Mindset Coaching Application w/ @bodyblissbyjess

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This is for women who desires a heart centered coaching partnership! 🫶 Please fill this in before our session so I can best support you!

Email *

First & Last Name *

Instagram Handle *

Phone # *

Which statements accurately describe where you're at? Check all that apply.*

I want to take my health to the next level (mindset, routines & rituals, nervous system regulation)

I'm want to develop a mindful eating practice with balanced nutrition support and mind-body practices

I want to sync my nutrition, movement, manifestations & career growth with my menstrual cycle.

I'm desiring a safe space to do the deeper work and take steps towards the 2.0 version of me!

I want to build unshakable confidence and solid self worth (without the need for external validation)

I want the tools & guidance to manifest my greatest desires and step into my highest potential

Other:

Which areas of your health & mindset are you desiring support? Check all that apply.*

Formulating supportive habits, routines & rituals

Balancing all areas of my life without overwhelm or burnout

Learning to trust myself and my own intuition

Emotional, spiritual & mental health support

Embracing my female body and learning how to cycle sync

Swapping scarcity for abundance mindset

Building stress resilience & supporting my nervous system

Other:

How would you describe yourself as a student/ client?

Self-Starter: I am very self-driven and don’t require a lot of hand-holding or regular check-ins.

Motivated & Goal Oriented: I am eager to learn and open to new ideas, but I thrive with accountability and regular check-ins.

Support-Seeker: I thrive with regular support, clear instructions, and a collaborative relationship with my coach, enjoying self-reflection

How committed are you to a private coaching partnership and investing in the highest version of you?

One-time support for a specific issue

A deeper dive with ongoing coaching

Not sure yet—open to exploring options

At this time, I'm not prepared to invest

Is there anything else you’d like me to know before our session?

Thanks for answering these questions and can't wait to support you! ❤️

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