Zen Supermom - Assessment Application

Zen Supermom - Assessment Application

This application helps us understand whether an assessment call is the right next step right now. Many moms who resonate with this work are overwhelmed, exhausted, and doing their best. There are no “right” or “wrong” answers here, only what best reflects your current reality. If now isn’t the right moment for an assessment call, we’ll still guide you toward the most supportive next step.
Q1. What made you apply for an assessment now?*
Q2. Right now, which feels most true for you?*

A. Even if life gets stressful, I can make it a priority to practice daily (2–5 minutes) if I start seeing real changeB. Right now, life feels so heavy that even small daily practices would be hard to keep up withC. I’m not feeling emotionally safe or stable at the moment
Q3. When you react with your child, what usually feels strongest in that moment?(Choose all that apply)*

Pressure / urgencyFeeling alone with everythingAnger that comes out before I can thinkShutting down / going numbOver-explaining / trying to control the situationPanic or anxiety in my body
Q4. What have you already tried to change this pattern? (Choose all that apply)*

Parenting courses or scriptsTherapy or counselingMeditation / breathworkSelf-help books or podcasts“Trying harder” / self-controlNothing yet
Q5. Which statement feels most true right now?*

A. I’m ready to be supported and don’t want to do this alone anymoreB. I’m curious, but not sure I’m ready for support yet
Q6. If accepted, what feels realistic for you right now?*

A. I can commit to small daily practices (2–5 minutes), even if I’m not perfectB. I could try, but consistency feels uncertain right nowC. Daily practice feels unrealistic at the moment
Q7. This work is a paid, guided process. Which feels most accurate right now?*

A. I can invest now, or within the next 2 weeksB. I’m not sure yet - I need to look at my financesC. I can’t invest right now (e.g. no income, benefits, financial instability)
Q8. What are you hoping this work would change for you or your family? (This doesn’t need to be perfect but honest.)*
Have you watched the Mommy Tantrum Session? (https://zensupermom.easywebinar.live/mommy-tantrum-training-registration)*

YesNo
Please confirm (ALL checks are required):*

I understand this application does not guarantee a callI understand the assessment is not a therapy sessionI understand this is a paid program if we move forward
Your name*

First NameLast Name
Your best email address where we can contact you back*
example@example.com
source
We will respond to your assessment within the next 2 work days, from hi@zensupermom.com email address. (Check your other spam folders, in case you don't see it in your mailbox by then.)
Should be Empty: