Coaching Application Form

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If you’re here, there’s a good chance you’ve been struggling with intrusive thoughts about your partner’s past for far longer than you’d like.

Private coaching is structured, practical work focused on identifying and breaking the patterns that keep those thoughts going.

Please answer the questions below as honestly and straightforwardly as you can. I personally review every application.

If everything aligns with your application, I’ll invite you to book a 30-minute discovery call by placing a fully refundable deposit.

On that call, we’ll discuss your situation, what may be keeping you stuck, and whether working together makes sense for both of us.

Don’t overthink your answers. Just tell me what’s really going on.

– Zachary
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Name:* This field is required.
First Name
Last Name
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Email* This field is required.
example@example.com
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Where did you hear about me?* This field is required.
BBC News, or other media
YouTube
RetroactiveJealousy.com
The Zachary Stockill Podcast
Instagram
Facebook
TikTok
Google
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Where do you live?* This field is required.
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How old are you?* This field is required.
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What is your profession?* This field is required.
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What are you struggling with most right now?* This field is required.
Intrusive thoughts about my partner's past
Questions about my partner's values
Worried I'm in the wrong relationship
I know I'm in the right relationship... I just can't stop thinking about their past
Other issues
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Where did you discover me and my work?* This field is required.
YouTube
Google search
Podcast
ChatGPT, Grok, or another AI app
Other
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When thoughts about your partner's past come up, what do you actually do next? (For example: ask questions, seek reassurance, compare yourself, replay details, check social media, withdraw, argue, or try to suppress the thoughts?)* This field is required.
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Roughly how much time per day are you spending thinking about this?* This field is required.
Less than 1 hour
1-3 hours
3-6 hours
6+ hours
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What have you already tried to solve this problem?* This field is required.
Talking to my partner
Therapy or counseling
Online content / videos
Trying to “figure it out” myself
Other
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How is this currently impacting your life and relationship?* This field is required.
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If this problem were fully resolved, what would be different for you?* This field is required.
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Why is now the right time to address this, rather than 6–12 months from now?* This field is required.
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Private coaching is not therapy or mental-health treatment. Are you currently experiencing suicidal thoughts or a mental-health crisis that requires clinical support?* This field is required.
Yes
No
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If we both decide this is a good fit, when are you prepared to start?* This field is required.
Immediately
Within the next 1–2 weeks
I don’t have a clear timeline
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For important professional and ethical reasons, I cannot work with clients who have been diagnosed with generalized anxiety disorder, clinical depression, and/or suicidal ideation. Have you ever been diagnosed with these symptoms?* This field is required.
YESNO
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For important professional and ethical reasons, I cannot work with clients who have been diagnosed with generalized anxiety disorder, clinical depression, and/or suicidal ideation. Have you ever been diagnosed with these symptoms?* This field is required.
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Private coaching is a three-month engagement. The investment starts at $5,000 USD. If we both decide we're a strong fit, which statement best describes you?* This field is required.
I’m financially prepared to make that investment if we decide to work together.
I’m financially able to make the investment, but I might need to make use of a two payment plan.
A mid-four-figure investment is not realistic for me at this time. I'd prefer a self-directed option.
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If you answered “yes” above, what would need to happen on the call for coaching to feel like a clear “yes” for you?
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If you decide to invest in one-on-one coaching, how are you hoping that I can help you?* This field is required.
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Before submitting your application, please confirm:* This field is required.
I understand that Zachary's private coaching program starts at $5,000 USD, and if Zachary and I determine we're a good fit, I am prepared to make that investment immediately.
I'm interested in coaching, but I'm not currently prepared to make a $5,000 USD investment. I would prefer a self-directed option.
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On a scale from 1-10, with 10 being the highest, how committed are you to reaching your goals and solving these problems?* This field is required.
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Is there anything else you'd like me to know?
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Depending on your needs, please note that an investment in a dedicated 1:1 coaching program starts in the mid-four-figures (USD). Which of the following statements applies to you?* This field is required.
I am financially secure, ready to commit, and eager to invest in a better future. Let's do this!
I am financially secure and eager to make an investment like this, but I have a few questions first.
I am unable to invest in 1:1 coaching. I'm looking for a self-guided option.
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