Coaching Application Form

1
If you’re reading this, there’s a good chance you’ve been struggling with intrusive thoughts about your partner’s past for far longer than you’d like.

If you’ve tried to solve this problem on your own—but still find yourself replaying the past, asking questions you later regret, or getting trapped in endless overthinking—you’re in the right place.

I’ve spent the past 13 years helping men and women from around the world overcome retroactive jealousy. If you’re looking for my personal guidance, this coaching program is the only way to work with me.

Before you begin, a few things to know:

This is structured, practical coaching with clear goals and accountability.

Together, we’ll identify and interrupt the patterns driving your intrusive thoughts—not just manage the symptoms.

I intentionally work with a limited number of private clients at any given time, so availability is always limited.

What happens next?

Please complete the short application below. I review every application I receive personally.

If I believe I’m the right person to help you, I’ll invite you to schedule a free discovery call by placing a fully refundable deposit.

During that conversation, we’ll get clear on your situation, identify what’s keeping you stuck, and decide whether working together is the right fit for both of us.

Please don’t overthink your answers. Honest, straightforward responses are far more helpful than trying to say the “right” thing.

I appreciate you taking the time to apply, and I look forward to reading your application.

- Zachary Stockill
2
Name:* This field is required.
First Name
Last Name
3
Email* This field is required.
example@example.com
4
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
5
Where do you live?* This field is required.
6
How old are you?* This field is required.
7
What is your profession?* This field is required.
8
Where did you discover me and my work?* This field is required.
YouTube
Google search
Podcast
ChatGPT, Grok, or another AI app
Other
9
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
10
When thoughts about your partner's past come up, what do you actually do?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
11
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
12
How is this currently impacting your life and relationship?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
13
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
14
Why is now the right time to address this, rather than 6–12 months from now?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
15
If this problem were fully resolved, what would be different for you?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
16
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
17
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
18
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.
Huge
Large
Normal
Small
Ok
Ok
19
If we decide this is a fit, do you currently have the funds available to invest in mid-four-figure private coaching (USD)?* This field is required.
Yes, the funds are available now
No, I do not have the necessary funds
20
If you answered “yes” above, what would need to happen on the call for coaching to feel like a clear “yes” for you?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
21
Please select the statement that best reflects where you are right now:* This field is required.
I understand the investment level and am ready to move forward immediately if this feels like the right fit.
I want help, but I’m not financially prepared for this level of coaching right now.
22
If you decide to invest in one-on-one coaching, how are you hoping that I can help you?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
23
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.
24
Is there anything else you'd like me to know?
Huge
Large
Normal
Small
Ok
Ok
25
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.
Should be Empty: