Chrysalis Contemplative Application Form

Thank you for your interest in personal evolution coaching with me via the Chrysalis Contemplative. This experience is a 3 month, 1:1 container to empower you to access your inner wisdom during life transition in order to create an aligned, artful authentic life.

Personal transformation is not a quick fix, nor is it a linear process. It is deep, layered work, and it asks for real time and real commitment. If you resonate with this work in this season, I invite you to apply below.

This form is designed to help me understand your background, goals, desires, challenges, and vision and to explore if this coaching experience aligns with them.

Because of the in-depth nature of this experience, please note that all responses are required, and I recommend that you set aside 30-40 minutes to complete this form thoughtfully and in a way that feels nourishing for you. So maybe that's with a cup of tea and a cozy blanket at home, reflecting at your favorite cafe or even finding a spot you love outdoors--whatever resonates for you.

The more honestly and fully you share, the better I can understand what's alive for you, so please don't hold back. I know transition is such a tender time, so know that I hold your responses with care <3.

DISCLAIMER & CONFIDENTIALITY:

While my work is trauma informed and sensitive, this work is not a substitute for therapy or trauma treatment. It is not appropriate for anyone currently in acute crisis or requiring clinical support. If you're unsure whether this is right for you, you're welcome to mention that in your application, and we can explore it together.

Confidentiality note: Your answers are seen only by me.

Thank you for being here <3,

Nyam Adodoadji

Personal Evolution Guide

Full Name

First NameLast Name

Preferred pronouns (he/him, she/her, they / them etc)

Email Address

example@example.com

Location (City, State, Country) (Note: I work with all clients remotely)

Time Zone

How did you hear about me?

What leads you to explore coaching via the Chrysalis Contemplative at this time?

In detail, please describe your current challenges and desires and how they relate to your vision, goals, or desired impact for your time in the Chrysalis Contemplative. You're welcome to note anything you feel is relevant in the realm of your life, work, relationships or other areas.

What have you tried so far to respond to the above challenges?

What transformation do you want? What would success look like for you after being a part of this experience? You're invited and encouraged to define success in your own terms.

This coaching experience invites you into a deep level of personal reflection and inner work. How do you currently reflect on your life, relationships and career and what resources, people or support help you do that?

My approach is client led and mind-body connection based, not just mindset work, which means: 1) I believe that you have the resources within you to create the life you want and that my role is to partner with you to trust and access them and 2) in order to experience lasting change, it comes from tuning into and acting from your body's inner wisdom. What is your experience with somatic or body based work? What questions do you have about it? There are no "prerequisites." I just want to understand your entry point to the work and invite you to ask any questions about this approach.

This experience is highly personalized, and I have a high level of 1 on 1 support, presence, accountability and guidance for my clients. I see this experience as a partnership in your exploration, personal growth and transformation. Are you ready and able to dedicate the necessary time and presence for meaningful work?

If applicable from your response to the last question, please note if there's anything you feel would make it difficult to dedicate the necessary time & presence to this work.

Are you ready to invest financially in coaching?

Is there anything else you'd like to let me know about you, your journey or your hopes for this work? Are there any questions that you have for me? (If not, you can simply put no)