Please complete this form to book your appointment
Help us understand your needs to determine if this course is right for you. This work is for women who know something in their life needs to shift. Women who feel disconnected, stuck, unfulfilled, or at a crossroads — and are ready to reconnect with themselves, their intuition, and the life they truly want to create. Please answer the following questions honestly and thoughtfully. This helps me understand where you are currently and whether this work is aligned for you.
Full Name
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First Name
Last Name
Email Address
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example@example.com
What is currently feeling most out of alignment in your life right now?
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What are you hoping will change through this work?
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What do you feel is currently holding you back? This could be emotionally, mentally, physically or spiritually.
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Have you done any personal development, healing, coaching or subconscious work before?
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yes
no
some
Why does now feel like the right time for change?
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On a scale of 1–10, how ready are you to take full responsibility for creating change in your life?
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Please enter a number between 1 and 10
This work requires openness, honesty and willingness to take aligned action outside of sessions. Are you prepared for that?
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yes
no
unsure
Which areas are you most seeking support with?
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Direction & purpose
Confidence & self-trust
Intuition & alignment
Life transition
Emotional patterns
Relationships
Identity shifts
Subconscious beliefs
Creating a more aligned life
What drew you to work with me specifically?
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Are you currently willing and able to invest in transformational support for yourself?
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yes
no
I need more information
If nothing changes over the next 12 months, how would that feel for you? Please answer below:
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Please answer below:
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I understand this is a focused discovery call, not a free coaching session.
I will attend at my scheduled time or provide notice if I need to rearrange.
I understand real transformation requires personal responsibility and action.
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