Application
What is your full name?
What is your email?
What is your phone number?
Were you referred by anyone? If yes, please provide their first and last name below.
What is one great thing that has happened to you recently?
What prompted you to apply for coaching and nervous system support?
What is your vision for your life?
What type of support are you desiring for yourself as a high achieving woman?
Have you worked with any coaches/mentors in the past? If yes, describe your experience.
Are you experiencing any of the following?
Can't stop worrying even if things are good on paper
Difficulty turning off and enjoying the present moment
A strong need to please people and have difficulty saying 'no' to requests
The feeling of urgency or there isn't enough time
A tendency to overwork
Difficulty resting or turning off in the evenings or on weekends
Putting off projects until the last minute when the pressure is high
Can manage a busy schedule but often experience overwhelm
Extreme fear of failure or criticism
Overanalyze or second guess your decisions
You often compare yourself to others
Consistently feel you aren't doing enough
Have lots of ideas but struggling with starting or implementing these ideas
Feeling consistently tired and overwhelmed
Regularly skip breakfast. Not hungry in the mornings.
Tightness in jaw, neck or shoulders
Searching on Zillow or constantly planning your next vacation
Sleeping with clenched fists or hands
Binge-watching. Spending hours watching back to back episodes.
Feeling on edge but you don't know why
Feel overwhelmed by small tasks
Spending a lot of time thinking vs feeling. ex. listening to podcasts, reading books, doing mindset work
Always desiring the next thing & having trouble enjoying the present moment
Consistent organizaing
Gravitating towards a minimalist aesthetic. Neutral colors such as white, grey & beige
Other
Do you identify with any of the following?
Hyper-independent
Perfectionistic
Prefer to move fast
Prefer to be in control
High performing
If you were to look back one year from now and say "Working with Dr. Jen was one of the best decisions I've made for myself..." What internal and external changes would make you feel thrilled about your transformation?
If it is aligned for us to work together, are you ready and able to invest in creating the transformation you truly desire?
YES I AM READY TO INVEST IN MYSELF
No I don't have the funds/I'm not ready to invest at this time
Is there anything else you would like me to know? Here is your private space to let it all out and be clearly heard. I am here for you!
Submit
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