1:1 Coaching Application

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Pronouns

4

Location/Timezone

5

What feels tender or heavy for you right now? * This field is required.

6

Have you ever worked with a therapist or coach before?* This field is required.

Yes, therapy

Yes, coaching

Both

No, this will be my first time

7

What kind of support do you find yourself craving most?* This field is required.

Gentle accountability (someone to check in & mirror back clarity)

Deeper companionship (voice notes, reflections, tools in-between)

A mix / not sure yet

8

Do you currently have the time and energy to meet weekly for 45 minutes?* This field is required.

Yes

No

9

Which container are you most drawn to?* This field is required.

Reintroduction (6 weeks, lighter touch, gentle reset)

Homecoming Hours (12 weeks, immersive + steady support)

I’m not sure — I want to explore this in the call

10

Why do you feel now is the right time to step into this support?* This field is required.

11

Is there anything that might get in the way of your commitment (schedule, finances, emotional readiness)?* This field is required.

12

Is there anything else you’d like me to know about you, your story, or how you want to be supported?

13

* This field is required.