Mindset & Menstrual Coaching

Mindset & Menstrual Coaching

1:1 coaching application form
A 1:1 coaching container designed to support you in reconnecting with your body, rebuilding trust around food and movement, and understanding your menstrual cycle on a deeper level.

This isn’t a training plan. This is where we do the inner work—the mindset shifts, the hormonal education, and the cycle syncing that your body’s been asking for.

What’s included:
— Initial intake discovery call

— Fortnightly zoom check-ins

— Fortnightly personalised recommendations

— Mindset coaching around food & exercise freedom

— Education on the menstrual cycle & interpretation

— Menstrual cycle tracking & temping via app

— Unlimited support & direct messaging with Victoria

— 12 week minimum commitment

This is perfect for women navigating missing or irregular periods, burnout from hustle culture, or just wanting to feel more aligned in their health journey.
Full Name

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

Area CodePhone Number
Age
Location
Occupation
Menstrual Health Background
Do you currently have a menstrual cycle?
If yes or irregular, when was the first day of your last period?
Do you have any children? If yes, explain briefly how your time being pregnant was and also your birth experience (specify natural/c-section and if you’ve had any previous miscarriages):
What does your current training look like?
Have you been diagnosed with any of the following? (Select all that apply)

Other
Have you, or are you currently, using hormonal birth control? If yes, please provide a timeline
Have you ever lost your period before? If so, for how long?
Movement History
Describe your current training or movement routine (type, frequency & intensity)
Do you feel pressure to train a certain way or amount? If so, where does that pressure come from?
What does rest look like or mean to you right now?
Nutrition & Mindset
Do you track your food intake?
Describe your relationship with food in 3 words:
How do you feel about “rest days”?
Do you ever experience guilt or anxiety around food and/or exercise? Please explain briefly
Goals & Support
What is your main goal in working with a coach?
What would be your top 3 goals for the next 12 weeks?
What would feeling more connected to your body look like for you?
Is there anything else you’d like me to know about before we begin working together?
Should be Empty:

Mindset & Menstrual Coaching

Menstrual Health Background

Movement History

Nutrition & Mindset

Goals & Support