Business Coaching Request Form

Free Breakthrough Session

Art that Heals
A Little About You

Thank you and Welcome - this exercise is a way for me to find out more about you and what support you feel you need. It's also a fantastic way for you to get super clear on where you are and where you want to get to! Let's see if we are a good fit to work together!
Hello friend, I'm so happy you're here!

If you landed on this page you have most likely come here to apply for a breakthrough session. In this session, we will get clear on your vision for breakthrough and the steps you need to take to get unstuck and thrive. I have a limited number of these sessions available each week. To be considered, please complete the form below giving as much detail as possible. Once we receive your application we will let you know if one of these limited spots is yours.

Lots of love,

Marjolaine
Name*

First NameLast Name
Confirm E-mail*
Phone Number*

Area CodePhone Number
Describe your situation and what breakthrough you are hoping to have.
What have you tried already to get healing and breakthrough?
Describe your biggest dream related to your creative calling or purpose.
What are the top three CHALLENGES you want to overcome now?
What SPECIFICALLY is stopping you from hitting these goals?
What FEARS do you have around healing and breakthrough?
What would it mean to you to reach this goal? (how would your life be different?)
Why SPECIFICALLY do you feel you need a coach?
What will be the most BENEFICIAL part of working with a coach?
What particular CONCERNS do you have about working with a coach?
On a scale of 1 - 10 (10 being highest) how important is it that you solve these challenges and why?
What is the number one obstacle that is stopping you from solving these challenges?
How ready and willing are you to INVEST in yourself and your healing? (Time, dedication, financial resources)?*
Are you willing to do what it takes, to challenge yourself, to get OUT of your comfort zone, eliminate excuses and be unstoppable towards your own success?*

Yes!No
About your financial resources & willingness to invest...

I have the financial resources to invest in my healing right nowI can generate the financial resources to invest in my healing as I go, but don't have all of the money on hand right nowI don't have the financial resources to invest in my healing any time soon
What I have learned most from this exercise / my biggest aha moment!
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Free Breakthrough Session

A Little About You