Break Free Session Application

For girls ready to break free from strict cultural rules and expectations — leaving behind fear and the Matrix to step into a life they actually want to live.

Thank you for expressing your interest in receiving support.

Together, we’ll explore how to overcome the barriers that are keeping you from experiencing freedom.

Please answer the questions below - there are no right or wrong answers. The more openly and from the heart you respond, the better we’ll be able to help you overcome those barriers.

Your responses will never be shared with anyone else, and will only be read by me.
Break Free Session Application
Name

First NameLast Name
Email
example@example.com
Age
Location
Have you ever received therapy or counselling before?

YesNo
My sessions use conversational hypnosis (a natural process that works with the subconscious mind). Are you open to this approach?

YesNoI'd like to know more first
In your own words, what feels the hardest about living life your own way? What is stopping you from feeling free?
What makes you feel ready to change this now?
What happens if you don't?
How did you find out about this offer?

Tik TokInstagramYoutubeThrough someone I knowOther
Because of the type of therapy I offer, sessions are results-driven rather than time-based. This means sometimes sessions are shorter than 60 minute, sometimes they are much longer - depending on when the breakthrough is reached. Are you comfortable with a flexible session length if the process requires it?

YesNo
If you’re successful in receiving the free session, we’ll first have a free 30-minute consultation call to prepare and ensure it's the right fit.

I understand and am happy to have this consultation call before my session.
Thanks for taking the time to fill out the form!
I’ll get back to you with an outcome within the next few days.
Take care until then ✨
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