3-month 1:1 The Empowered You Application Form

Application Form: The Empowered You

Thank you for your interest in "The Empowered You" 1:1 Coaching Container! Please fill out this form to help me understand how I can best support you in regaining control over your stress response and tapping into the most empowered version of you.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Instagram Handle*
@example
Age
@example
Occupation
@example
What are currently your biggest challenges with stress and overwhelm?*
(Feel free to elaborate!)
How is stress affecting your daily life?*
(Consider its impact on your energy, relationships, and overall well-being)
What methods have you tried to manage stress (e.g., therapy, mindfulness apps, retreats)? What worked or didn’t work for you?*
What attracted you to me and the 1:1 Coaching Offer, and why is now the right time for you?*
Describe your dream life once you've transformed your relationship with stress? What do you want to achieve or feel?*
Are you committed to investing in yourself and making changes to your current habits and patterns in order to level up?*

YesNo
What specific benefits and results would you expect to receive throughout our time working together? *
Thank you for applying!

If selected, you’ll receive an email within the next few days to sign your agreement and book in our Intial Call and first Consult and guided Breathwork. I can not wait to connect with you and support your journey toward stress resilience and the life you desire!
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Application Form: The Empowered You