Application for The Graceful Way®

Thank you for your interest in The Graceful Way®. This programme is designed for people who are ready to approach things differently - not just talk about change, but experience it. This short application helps me understand where you are right now, and whether this is the right fit for you.
Application for The Graceful Way ®
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Email Address*
example@example.com
Date of Birth*

MonthDayYear
What’s been feeling most challenging for you recently?*
When things feel difficult, what do you notice about how you currently respond?*
What would you like to be different in how you handle things day-to-day?*
What drew you to The Graceful Way® specifically?*
On a scale of 1-5, how ready do you feel to approach things differently right now?*

1

2

3

4

5

1 is Not Ready, 5 is Full Ready
Have you tried anything before to shift this? What did or didn’t help?
Are you able to commit to the full 8-week programme? Options: Yes, Not fully sure yet*

YesNot fully sure yet
Anything else you’d like me to know?
GDPR Compliance Notice: By submitting this form, you consent to the processing of your personal data in accordance with GDPR regulations. Your information will be handled securely and used only for the purposes of this application.
Information Sensitivity and Confidentiality Statement: All information provided in this application is treated with strict confidentiality and sensitivity. Vivid Outcomes is committed to protecting your privacy and ensuring your data is secure.
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Thank you for your interest in The Graceful Way®. This programme is designed for people who are ready to approach things differently - not just talk about change, but experience it. This short application helps me understand where you are right now, and whether this is the right fit for you.

Application for The Graceful Way ®