Self-love + Mindset + Breathwork Mentorship Application
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
How did you hear about Brigitte?
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Please Select
EMAIL
WEBSITE
SOCIAL MEDIA
REFERRAL
OTHER
OTHER
Which program are you interested in?
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Please Select
Living Your Life on Purpose - 4 session series
Elevate - 12 session series
Which of the following statements best describes you?
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I want more time for myself and the things I enjoy
I want to improve the relationship with myself and others
I want to be more focused, relaxed and centered
I want to experience more joy and freedom in my life
Other
What is the current, single most important goal that you want to reach?
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What do you feel is your biggest obstacle to achieving your goal?
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What have you tried in the past that didn't work?
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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)
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Do you have any questions for me, or is there anything else you'd like to add before our call?
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Thank you, I'll be in touch soon to schedule a call
~Brigitte Toussaint
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