Getting started on your journey
Ready to take the first step towards feeling better? These quick questions should only take 2-3 minutes to complete, and your answers will help guide us towards offering you the best support.
What's your biggest challenge now that you are looking to change?
Constant fatigue and lack of energy
Unexplained aches, pains, or digestive issues
Feeling emotionally overwhelmed or anxious
Difficulty getting clear answers from doctors
Struggling to concentrate or experiencing brain fog
Feeling disconnected from my body and unsure what it needs
Frequent mood swings or emotional outbursts
Feeling like I've lost my sense of joy or motivation
Other (please specify)
How long have you been experiencing these challenges?
Less than 6 months
6 months to a year
1-3 years
More than 3 years
If you have had therapy, what modalities have you used?
Psychology - Talk therapy
EMDR / DNRS / Somatic Tracking
NLP - Neuro Linguistic Programming
EFT - Emotional Freedom Technique
Hypnosis / Hypnotherapy
CBT / ACT / Body Code
IFS - Internal Family Systems / Family Constellation
Other (please specify)
If you can't afford one-on-one sessions, would you consider small group session work and what would be important to you?
Live Coach guidance at every meet-up
Access to lesson replays
Coach support outside the group setting
Confidentiality / Privacy
Support within the group
Having fun
Schedule flexibility
Length of time per group meet-up
Length of time for the entire Program
Affordability / Payment plan
Other (please specify)
On a scale of 1-10 (with 10 being extremely ready), how ready are you to finally find relief and feel more like yourself?
Not Ready at All
1
2
3
4
5
6
7
8
9
Ready to Take Action
10
1 is Not Ready at All, 10 is Ready to Take Action
First Name
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Your Email (to discuss your needs further - I do not share emails with others)
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Contact number
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