Application to work with Teresa 1:1
*** ANY INFORMATION YOU SHARE WILL BE KEPT CONFIDENTIAL. ***
What is your first name?
What is your email address?
example@example.com
Approximately where in the world are you?
What made you reach out? Please describe the relationship issue(s) and/or challenge(s) that you'd like help with.
How are these challenges affecting your well being?
What have you already tried? What were the results?
Who or what else is being impacted by these issues, and in what ways? (Examples: children, pets, passion projects, work life, friendships...)
How will your life be different when these challenges are resolved?
Are there additional cultural, social, situational or family aspects at hand that I should know about? Please describe.
Are you willing to commit to an intensive process of self discovery and skill building to call forth your most authentic, loving, powerful self?
YES, I'm readyyyyyyy!!!!!
Eeek, I'm scared but... I think so!
I'm skeptical but interested in the possibility.
Nah, I just want others around me to change.
In the upcoming week, what are your best days and times for a free consultation? [You will need to set aside 45-60 minutes free of distractions with a solid internet connection.] PLEASE SUGGEST TWO OR MORE OPTIONS.
Please acknowledge that you understand filling out this application does not guarantee a consultation appointment or constitute an agreement to work together. Applications will be reviewed and responded to on an individual basis, usually within 48 hours.
I understand and agree to the above statement.
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