Group Recovery Coaching Application

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Once you have completed this form, you will be contacted by Emma within 24 hours.

Email *

Full Name *

Timezone *

Recovery coaching is only available to those who are aged 25 years old or above. Please confirm that you are aged 25 years old or above. *

I confirm that I am aged 25 years or above.

Required

Why would you like to work with me? *

Please describe your current situation and what you struggle with the most. *

Please briefly describe what your ideal life would look like if you were to achieve a full recovery. *

Are you 100% committed to putting in the time, focus, and action that’s necessary to make your vision of a full recovery possible? *

Yes

If we get on a discovery call and identify as a good fit to work together, then are you willing to make the investment in yourself to hire me as your coach? *

Yes

How did you discover B-Free Recovery? *

Please confirm the following. 1) I understand that B-Free Recovery coaching cannot provide medical treatment or diagnosis. 2) I understand that this program is not meant to diagnose, treat, or prevent any disease or illness. 3) I understand that I am responsible for my own health at all times, and I am advised and expected to use any coaching in conjunction (not in lieu of) with professional medical advice. 4) I understand that with any changes in lifestyle, there are certain risks involved, and I take full responsibility for my health and my choices. *

I confirm.

Send me a copy of my responses.

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