This is a safe space to share where you’re at. You don’t need to have everything figured out - this is simply the first step.
About You
Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Preferred Contact Method
*
Phone
Email
Text
What’s Bringing You Here
What feels most relevant for you right now?
Feeling overwhelmed or burnt out
Struggling with motivation or direction
Feeling isolated or disconnected
Navigating a life transition
Wanting support with emotional wellbeing
Not sure — I just know I need support
Your Current Situation
Tell me a little about what’s been going on for you:
Anything you may like to share for me to understand your current situation better?
What You’re Looking For
What are you looking for right now?
1:1 support
Community / social connection
Guidance and structure
Not sure yet
Availability
Preferred Days
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Preferred Times
Morning
Afternoon
Evening
Flexible
Suburb / Location
Readiness
Are you ready to begin support soon?
Yes - I’m ready to get started
I’m exploring my options
Consent
I’m happy to be contacted by Core Support Collective
*
I’m happy to be contacted by Core Support Collective
I understand support will be tailored to my individual needs.
*
I understand support will be tailored to my individual needs.
Take the First Step
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