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example@example.com
1. What has been your biggest takeaway or “aha moment” from my socials, podcast and/or book?
2. How has this insight or message influenced your life?(For example: have you made changes in your mindset, daily habits, relationships, or how you handle challenges?)
3. What positive outcomes or shifts have you noticed since implementing these changes?(Feel free to share big or small wins — they all count!)
4. What area of your life do you most want support with right now?
Rebuilding after loss
Strengthening resilience and mindset
Manifesting new opportunities or goals
Cultivating gratitude and presence
Other
If 'Other' selected above please specify
5. Which of the following offerings most interest you?(Select any that you’d be drawn to explore.)
✨ Manifest Like a Mofo Blueprint
🌿 Resilience Mindset Workshop
🤰 Why Mindset Matters in Childbearing
6. Which format would best fit your lifestyle and learning preferences?
3-day / 2-night retreat (includes ongoing remote support after)
2-day in-person workshop + follow-up support
28-day online course (weekly Zooms + self-guided work & accountability tasks)
6-week online program (weekly sessions, deeper immersion + integration support)
7. What would make a workshop or program feel most valuable to you?(e.g., more community, hands-on guidance, reflection time, tools/resources, etc.)
8. Would you like to be notified first when new programs or retreats open for registration?
Yes, please!
Not right now :-)
💛 Thank you for taking the time to share your experience and input. Your voice genuinely shapes the work I create — I believe everything in life is a lesson or a gift, sometimes both, and your insight helps turn both into something powerful for others, too.
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