Talesha Kim 1-on-1 Consultation Application
Please fill out this form as accurately as you can. After submitting the form, you will be taken to my Booking Calendar page to schedule a time to meet with me. I'm so looking forward to meeting you!
Name
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First Name
Last Name
Phone Number
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-
Area Code
Phone Number
Email
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example@example.com
What type of grief are you struggling the most with? Death, Divorce, medical/mental health diagnosis, abuse, job loss, friendship loss, painful relationships, loss of identity/connection to self, loss of opportunity. Please share below.
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What would you like Talesha to know about this and or your life story leading up to it?
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How long has this been an issue?
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What have you tried doing to solve this problem? What has worked and what hasn't worked?
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What would you like to experience more of and how would it feel?
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In the past what has stopped you from seeking help?
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What are your 3 biggest fears and challenges?
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What are 3 goals you would like to accomplish this year?
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Are you willing to create new habits and patterns in your life?
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Yes
No
On a scale of 1-10 how ready are you to invest in grief coaching for your life right now? 1- not at all, 10- Sign me up now.
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Why are you at that particular number?
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Which of the following describes you?
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I'm ready to invest right now
I know it's an investment and am willing to invest in myself
I don't have resources to invest in my healing
I'm interviewing many people and seeing who is a best fit
Other
Talesha will recommend one of her healing packages that will best meet your needs and help you to become the person you want to become. This will be a time for you to make an empowered choice for what you want for your life. She asks that you come prepared to say YES or No to the program offered before the meeting. If you need to involve a spouse in your financial decisions talk with them before the consultation or bring them along for it. By doing this consultation you agree to have her discuss a package with you and have a decision by the end of the consultation. Do you agree to this?
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Yes
No
What specific questions do you want to cover with Talesha?
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Submit
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