Coaching with Dr. J Application

1
Name* This field is required.Your safety and comfortability is important to us. All information is kept private and confidential. I want to hear more about your needs and desires to see if we are a great fit to work together. You will hear from me and my team within 72 hours. Don't forget to check your spam!
First Name
Last Name
2
Email* This field is required.Please enter the email you would like to use to receive communication from us.
example@example.com
3
Phone Number* This field is required.This will be kept private and confidential.
Please enter a valid phone number.
4
4. What is causing you the most stress at the present moment? Please share in detail.* This field is required.
Huge
Large
Normal
Small
Ok
Ok
5
5. How are the things you are struggling with impacting other areas of your life?* This field is required.ie. work, parenting, relationship, friendships, low libido, energy, etc.
Huge
Large
Normal
Small
Ok
Ok
6
6. What is at stake if nothing changes? * This field is required.
Huge
Large
Normal
Small
Ok
Ok
7
7. How would it feel to have the things you discussed above improve by 30%?* This field is required.How would it feel? What would you do/have time for? How would your relationships change?
Huge
Large
Normal
Small
Ok
Ok
8
8. When you think about the connected, fulfilled, whole version of yourself, what would she be able to accomplish?* This field is required.What would you do if you felt your best and operated at your optimal functioning?
Huge
Large
Normal
Small
Ok
Ok
9
9. Why now?* This field is required.Why are you ready to take the leap now?
Huge
Large
Normal
Small
Ok
Ok
10
What are you willing to do in order to achieve the connection, fulfillment, and grounding in your Feminine Energy that you desire?* This field is required.What are you willing to do for better health, more wealth, more connected relationships and better sex?
Make time for myself to do the work
Set better boundaries
Invest in my growth (4-5 figures)
I will do anything
11
How did you hear about The Pleasure Collective?* This field is required.Referral? Instagram? Podcast? I'd love to know!
Should be Empty: