Breakthrough Anxiety Reset™ Waitlist

Breakthrough Anxiety Reset™ Waitlist

Complete the form below to secure your spot on the waitlist for the next enrollment of the Breakthrough Anxiety Reset™ program. By submitting this form, you qualify for an exclusive special rate of $497 (a $997 value)!
Name*

First NameLast Name
Phone Number

Area CodePhone Number
E-mail*
example@example.com
Date of Birth

MonthDayYear
Date
How would you describe your current anxiety level? (scale 1–10)
What’s your main reason for joining this program? (short answer)
Are you currently working with a therapist or other mental health professional?
Are you aware that this program is for ages 14 and above?
Are there specific fears or limiting beliefs you want to address?
What would success look like for you after this program?
Have you previously participated in any mindfulness, coaching, or therapy programs? (yes/no + brief explanation)
Are you interested in receiving early access to bonuses or VIP upgrades?
Are you interested in private coaching sessions in addition to the program?
Thank you for submitting your information! Once your submission has been reviewed and approved, you will be contacted with details about a special rate for the Breakthrough Anxiety Reset™ program. We’re excited to have you on the waitlist and can’t wait to support you on your journey to reduced anxiety and renewed confidence!
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