Your name
First Name
Last Name
What are some words you would use to describe yourself?
How long have you been on your personal empowerment/growth/healing journey?
12 months or less - it's fairly new to me!
1-3 years
3-5 years
5 + years
Share a bit about your current goals for self-love or personal empowerment in a few sentences.
What do you feel your biggest obstacles or challenges are to living as your most authentic self? Do you currently feel "stuck"? If so, in what ways?
Please share the types of healing modalities and approaches to personal development you have explored - and what do you find works best for you?
Have you ever been a part of a community or group container?
Yes! I thrive in a group setting.
Not really, this is new for me.
What are you MOST interested in?
Mindset work - learning and gathering new tools
Self-love - gaining self-understanding and strengthening relationship to self
Energy work and somatic healing - healing the nervous system & energy
Community - being in a space with like-minded, high-vibe women
What other aspects of this community appeal to you?
Do you consider yourself committed, coachable, ready to show up for yourself and get out of your comfort zone?
Not sure
Not sure but willing to learn and ask for help
Yes, it may be a challenge but I am committed.
Absolutely, I am ready.
What is your current personal development / growth and healing journey monthly budget or allowance?
$100 or less
$100-300
$300 or more
Your email address
example@example.com
Your Instagram
Your phone number
Please enter a valid phone number.
Format: (000) 000-0000.
Your preferred communication channel
Email *PLEASE CHECK JUNK*
Text message
Instagram
WhatsApp
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