1:1 Private Coaching With Amy Application
After you fill out the application, please click the submit button at the bottom of this page. Amy will be in touch with you over email within 24-72 hours to set up a 10 minute consultation call. Please fill in as much detail as possible.
Email address *
Full Name *
Your answer
Age *
Your answer
What Is The Best Phone Number To Reach You? *
Your answer
Which Country Do You Reside In? *
Your answer
What Is Your Occupation? *
Your answer
If you had a magic wand, what would you change about your health and life right now? Tell me what it is you're hoping to achieve with your health, mind, body & spirit. *
Your answer
What is the biggest barrier holding you back from achieving your most desired life and being your highest self? *
Your answer
Prior to reaching out to Amy, what have you already tried to achieve these desires and goals? Were some more successful than others? Please describe. *
Your answer
If accepted by Amy into this program, do you have the love and support from close friends and family members who will be supportive of you on this healing journey that we'll be embarking together? *
Your answer
Amy's only accepts students and clients who are willing to put in the work. Will you be able to invest the time required in order implement Amy's recommended steps? *
Anything else that you would like to let Amy know before your consultation call? *
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy