OFFICIAL PROGRAM APPLICATION & WAITLIST FOR PRIVATE CLIENT INTAKE
The DITCH it. With EASE. And THRIVE Program

YAY! I'm so excited you are here and applying to join my 3 month, 100% Personalised & 1:1 Coaching Program to DITCH it. With EASE. And THRIVE!

For more information about the program go to:
www.instagram.com/stories/highlights/17868930344088158

If you have any questions about the program or working with me, please leave your questions in the below form.


Once you apply here, and a place becomes available, I will be in contact with you directly to arrange a free-of-charge 30-45 min clarity call to confirm if my DITCH it. With EASE. And THRIVE Program is an appropriate fit for you to finally Say Goodbye to what has holding you back!


Looking forward to connecting with you further

Lisa Gumieniuk :-)

Email: lisa@lisagumieniuk.com
Insta: www.instagram.com/lisagumieniuk
FB Page: www.facebook.com/LisaGumieniukCoach
FB Group: www.facebook.com/groups/chaostoclarityreset
Linkedin: www.linkedin.com/in/lisa-gumieniuk
Email *
I have a very limited capacity to take on new clients at any given time and only work with clients who are 100% ready to invest, commit to themselves and start to THRIVE with EASE! Are you ready to INVEST, COMMIT & THRIVE NOW? *
First and Surname *
Location (Suburb, State, Country) *
Phone number (including area code) *
Why would you like to join the DITCH it program? And WHAT are you wanting to DITCH? (i.e. Anxiety, Stress, Burnout, Chronic Illness, Depression, Stuckness) *
In a sentence or two, please tell me a little about your CURRENT situation? *
Where do you WANT TO BE? (i.e. What are you ultimately trying to achieve for yourself & in life? What goals or intention do you have for yourself? How would you like to feel, think, be or create?) *
What do you believe is currently STOPPING you from achieving your goals? (Please outline all roadblocks, challenges, what is holding you back both within and outside of your control). *
What have you tried in the past that you feel has NOT helped you? (Please list ALL habits, self practices, therapies, therapists/practitioners, courses, retreats etc.) *
What have you tried in the past that you feel HAS helped you? (Please list ALL habits, self practices, therapies, therapists/practitioners, courses, retreats etc.) *
On a scale of 0-10, how important is it that you solve this issue at the moment? *
Least Important
Most Important
What would it be like if you’re still in the same position in 6-12 months time? *
If you were to 'DITCH IT' and reach your goal how do you think that would impact your life? (i.e what would life be like for you? What would it look like? What would if feel like? What would it mean to you to DITCH IT?) *
On a scale of 0-10, how committed are you to investing the time and money required to join this program and work with me? *
Least Committed
Most Committed
If there anything else you'd like to share with me? Do you have any questions for me about the program?
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