Limitless Ability Healing Collective
Please fill out this form to help us understand your needs and support your spiritual and emotional growth.
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What brings you to Limitless Ability Healing Collective?Please select all that apply:
Christian Mental Health Coaching & Mentoring
Grief, Loss & Bereavement Support
Trauma Recovery & Emotional Healing
Addiction Recovery & Life Restoration
Identity, Purpose & Spiritual Growth
Military, Veteran & First Responder Support
The Table: Psalm 139 Families
Beneath His Wings
Workshops, Retreats & Discipleship Gatherings
Speaking Engagements
Church & Ministry Consulting
Other
Tell me a little about your current season of life.
What challenges are you currently facing?
What are you hoping God will do in your life through coaching, mentoring, or community?
What would you like to be different six months from now?
Are you currently attending a local church? Or are you looking? If yes, please share the name of your church:
What are you hoping God will do in your life through coaching, mentoring, or community?
Are you currently working with any of the following?
Licensed Mental Health Counselor
Psychologist
Psychiatrist
Pastor
Recovery Program
None of the Above
Other
What days would be best to connect? Indicate availability Monday through Friday
What time of day would be best to connect? Indicate availability between 9 am and 4 pm.
Coaching Acknowledgement & Professional Disclaimer. Please type "YES" in the box below to acknowledge that you understand the following: I understand that Limitless Ability Healing Collective provides Christian mental health coaching, mentoring, discipleship, education, and support services. I understand that Katie Anderson is not a Licensed Mental Health Counselor (LMHC), psychologist, psychiatrist, physician, attorney, or medical provider. I understand that coaching services do not include diagnosis, psychotherapy, counseling, psychological evaluations, crisis intervention, legal representation, or medical treatment. I understand that participation in coaching services does not establish a therapist-client, counselor-client, medical, legal, or clinical treatment relationship. If I am experiencing a mental health crisis, thoughts of self-harm, suicidal ideation, abuse, addiction requiring medical intervention, or any condition requiring diagnosis or treatment, I understand that I should seek immediate assistance from a licensed mental health professional, physician, or emergency services or call 911. Type "YES" below:
Signature
Continue
Continue
Should be Empty: