Self-love + Mindset + Breathwork Mentorship Application

Self-love + Mindset + Breathwork Mentorship Application
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
How did you hear about Brigitte?*
Which program are you interested in?*
Which of the following statements best describes you?*

I want more time for myself and the things I enjoyI want to improve the relationship with myself and othersI want to be more focused, relaxed and centeredI want to experience more joy and freedom in my lifeOther
What is the current, single most important goal that you want to reach?*
What do you feel is your biggest obstacle to achieving your goal?*
What have you tried in the past that didn't work?*
How much of a priority is this for you right now in terms of investing to solve this problem, on a scale of 1 to 10? (1=not a priority and 10=urgent)*
Do you have any questions for me, or is there anything else you'd like to add before our call?*
Thank you, I'll be in touch soon to schedule a call

~Brigitte Toussaint
Should be Empty:

Thank you, I'll be in touch soon to schedule a call