COACHING WITH JESSICA REGISTRATION

Welcome,

I am so glad you are here. It takes courage to sign up and talk through things but it's clear indicator that you are willing to take the first steps in transforming your life for the better.

In 60 minutes, I believe you can get clear on your relationships, goals, confidence, growth and much more

Together, let's create a new version of you.

I work with my clients, 1:1 to achieve excellent results. Be prepared to invest in your emotional wellbeing with time and patience.

Please take your time to fill out the information below to the best of your ability.

I am so excited to work with you!

Full Name *

First Name Last Name

e-mail address *

example@example.com

Mobile Number *

Gender

Female Male Non-binary

Strengths Finder:

Take your time in answering the following questions. Always know – what is shared here, is shared for us to use in support of your growth. Nothing will go beyond our conversations without complete agreement from us both.

What topic would you like to work on for 60 minutes?

Self-worth and Self-love Attachment Styles Inner-healing Relationships Growth and Confidence Intimacy Understanding your menstrual cycle (women only) New Yoga Teacher Mentoring

Please describe yourself:

What do you love most about your current life?

What do you love least about your current life?

What are your current top 3 biggest life challenges and why?

Describe as best as you can your week daily routine?

What are you currently focusing your energy and attention into bettering during the next 4 months?

Describe your ideal day:

List 3 short-term goals you would like to work on with measurable results for each over the next 30 days (Hint: keep these simple)

What do you think is holding you back or has slowed your progress up to now (resources, understanding/knowledge of new tools, friends, family, mentors, inner mindset)?

If you could change ONE thing in your life right now- what would it be ?*(Hint – don’t overthink on this one – go with the first thing that pops into your mind.)

What are the negative things you typically tell yourself? (Make a list, please.)

Results are an issue of personal responsibility simply signing up to work together is no guarantee that you will achieve results. BUT please know I am committed to your progress and need you to do the same for yourself.

Are you ready and willing to make the changes necessary to achieve your goals?

YES

What is the most empowering and helpful thing I can do for you during our time together?

What are your preferred coaching days in a week? *

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

What are your preferred time slots? *

10:00 - 12:00 12:00 - 14:00 14:00 - 16:00 16:00- 18:00 20:00 - 22:00

A note about me: I work best with those who are willing, rather than those who doubt or resist everything. What it comes down to is: I truly want the best results for you out of our work.

Hooray! You have already completed the inital steps to our 60 minute call.

I will be in touch shortly with some dates and times to call.

Thank you

Jessica

IMPORTANT NOTE

All the necessary information shared by you during the entire process will be treated as confidential and will not be shared with any third party.