Apply to Life Beyond Hurt w/ Jen Ahana

1
How old are you?
20-29
30-39
40-49
50-59
60-69
70+
2
How would you describe your current professional status?
Professional (Employed)
Entrepreneur/Business Owner
Stay at Home Parent
Retired
Student
Unemployed
Other
3
Describe a recent situation where you felt your emotional wounds resurface?* This field is required.
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4
Which of the following red flags are you experiencing? (Check all that apply)
Difficulty forming meaningful relationships
Chronic negative emotional states (anxiety, depression, burnout)
Frequent mood swings
Emotional numbness
Substance abuse or other addictive behaviors
Incessant self criticism or self loathing
Replaying past memories or regrets
Excessive desire for control, importance, and validation
Self sabotaging behaviors (doing things that get in the way of your happiness, health or success)
Health ailments (examples include hormonal imbalances, heart issues, weight gain, chronic pain, etc.)
Prone to distraction, daydreaming, desire to escape, unable to focus on present moment
Tendency to overwork
Negative patterns keep showing up in your life
Feel like you are hiding behind a facade
5
Which of the following childhood experiences have happened to you? (Check all that apply)* This field is required.
Neglect
Emotional abuse
Physical abuse
Parental absence
Bullying
Lack of Love or Validation
Criticism/Never Good Enough
Other
6
Could you share how these childhood experiences have shaped your beliefs, behaviors, or relationships as an adult?
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7
Have you experienced any of the following traumatic events? (Check all that apply)
Accidents or Natural Disasters
Loss of a Loved One
Medical Trauma
Assault
Emotional Betrayal
Divorce/Ending of Significant Relationship
Other
8
How do you feel these traumatic events have impacted your emotional well-being and your ability to cope with life's challenges?
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9
Which of the following types of regrets do you identify with the most? (Check all that apply)
Missed Opportunities
Relationships
Career Choices
Life Choices
Financial Decisions
Personal Behaviors (Addictions, self sabotaging, etc.)
Health Habits
Other
10
Could you share how these regrets weigh on your daily life or hinder your personal growth?
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11
What triggers do you often find yourself reacting to? (Check all that apply)
Specific people (e.g., family, friends, coworkers)
Emotional states (e.g., stress, loneliness)
Environmental cues (e.g., places, dates)
Thoughts or memories
Relationship dynamics (e.g., conflict, intimacy)
12
If you continue on your current path without healing, what are the potential consequences you foresee?
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13
What methods or programs have you tried before to heal, and why do you think they didn’t work for you?
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14
What's the number one thing you're willing to commit to for your healing journey?
15
On a scale of 1-10, how committed are you to actively participating in the program and doing the necessary work for your emotional healing? (1 being not committed, 10 being fully committed)
16
Imagine a life where you're free from the emotional weight you're carrying. What would that life look like, and what would you hope to achieve?
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17
Investing in your emotional healing is one of the most important commitments you can make for yourself. It's a declaration that you're worth the time, effort, and resources needed to lead a more fulfilling life. With that in mind, are you financially prepared to invest in your healing journey at this time?
Yes, I am fully committed and financially prepared to invest in my emotional well-being.
I have some concerns, but I'm open to exploring payment plans or other options.
No, I am not able to make a financial commitment at this time.
18
We prioritize transparency and respect for each other's time, which is why we've outlined our coaching options below. This ensures a focused and efficient experience for everyone.At Life Beyond Hurt, we offer two distinct coaching experiences tailored to meet your needs on your journey to healing and growth. Please take a moment to review the options below and select the one that resonates most with you:
Self Study Program
Program + Group Coaching
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We prioritize transparency and respect for each other's time. Please know that working together requires a commitment both personally and financially. If you are currently unable to meet the financial requirements for the options below, we kindly ask that you delay filling out the application until you are ready. This ensures a focused and effective experience for everyone. Which level of support are you most interested in?(Extensive details will be provided for both options if approved. Payment plans available and all major credit cards accepted.)
8 Week Program + 3 Months of LIVE Coaching ($3,500)
INTENSIVE: 12 Week Program + 3 Months of LIVE Coaching + Private Coaching Help Desk ($5k)
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Is there anything you feel we should know about you that hasn’t been covered in these questions or in the masterclass?
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21
What's your name?* This field is required.
First Name
Last Name
22
What's your email address?* This field is required.We will use this to reply to you.
example@example.com
23
What's your phone number?* This field is required.We'll use this to send you updates to your application status
24
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