Inner Compass Application Form

1
Name* This field is required.
First Name
Last Name
2
Contact Information
Please enter your email
Please enter your phone
3
What has you seeking support right now? Why now — not later?* This field is required.
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4
If this chapter of your life had a movie title, what would it be?* This field is required.First thought = truest thought.
5
What do you want that you don’t currently have?* This field is required.
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6
If that changed, what becomes possible for you? Think relationships, purpose, confidence, self-trust.* This field is required.
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7
What pattern are you ready to break and leave behind?* This field is required.
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8
What fears or resistance come up when you imagine actually changing?* This field is required.This is honest territory. No judgment here
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9
Is there anything about your identity or lived experience you’d like me to know so I can support you more fully?This space welcomes your full truth.
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10
How willing are you to step into discomfort and growth?* This field is required. (1 = not at all, 10 = let’s fucking go)
11
Why this space? Why me? Why now? What tells you this is the right fit?* This field is required.
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12
Coaching is a transformational investment of time, energy, and finances.* This field is required.
Hell yes
I believe so — and I’m ready to explore options
Not at this moment
13
If we start tomorrow, what’s one courageous action you’re willing to take immediately?
14
How have you invested in your personal growth in the past? What did you learn from those investments?* This field is required.
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15
I understand this is not therapy* This field is required.
YESNO
16
I am responsible for taking action between sessions* This field is required.
YESNO
17
I show up fully or reschedule with 24 hours’ notice* This field is required.
YESNO
18
I value accountability as a form of support* This field is required.
YESNO
19
I communicate honestly, even when it’s uncomfortable* This field is required.
YESNO
20
Check all that feel true for you* This field is required.
I’m done self-abandoning
I’m ready to lead my life fully
I’m willing to get uncomfortable
I am ready to invest in my transformation
I feel my Inner Compass pointing me here
Should be Empty: