Paid Femme form

1
What's your name?* This field is required.
First Name
Last Name
2
What’s your best email?* This field is required.This is how I'll follow up with you
example@example.com
3
What do you do for work right now?* This field is required.
4
In what area of your life are you craving more softness, support, or healing?* This field is required.select as many as you feel necessary
Healing my emotions and nervous system
Healing my emotions and nervous system
Allowing myself to rest, slow down, and feel safe
Receiving — love, money, support, or pleasure
Embodying my feminine energy more fully
Rebuilding my self-worth and confidence
Feeling safe to let go of control and trust
Other
5
Which patterns do you recognize in yourself?* This field is required.Choose as many as relevant to your current experience
I struggle to ask for or receive love, help, or support
I feel guilty when I rest, succeed, or enjoy life
I suppress my emotions or overthink instead of feeling
I sabotage good things in love, life, or success
I feel like I always have to be the strong one
I find it hard to trust others or feel safe letting go of control
6
How are these patterns impacting your emotions, self-worth, relationships, or day-to-day life?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
7
What would it look and feel like if this was solved 6 months from now?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
8
Why do you feel The Feminine Reset could be right for you?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
9
Anything else you want Urania to know about you or your story?
Huge
Large
Normal
Small
Ok
Ok
10
How much have you invested in your personal growth before?* This field is required.mentorship, coaching, or courses
Over $5,000
$1,000–$5,000
Less than $1,000
I’ve never invested before
11
Are you in a place to invest in the level of transformation you’re craving?* This field is required.
YESNO
12
We’re opening up 5 intimate spaces inside The Feminine Reset™ at a special founder’s rate of $997 (normally $2000+). This is a soft yet powerful healing journey to help you reconnect with your feminine energy, feel safe to receive, and rewire the beliefs that keep you stuck in survival mode. Click YES to schedule a call and see if it's right for you* This field is required.YOU"RE QUALIFIED✨
YESNO
Should be Empty: