The PMDD Program Application
Hi there angel! 🧡

Thank you for your interest in applying to the PMDD Program, which will help you heal from within and reclaim your power. To better understand where you are at in your health journey, please answer the following brief questions. You will be receiving an email shortly as to your application status for this life changing program!

The purpose of this form is to make sure that we're both a great match for each other so that you receive the most benefit from the PMDD Program, and so that I can better understand how we can work together to heal from the root, since this program is completely personalized to you. If you have any questions or concerns, please shoot me an email at periodpmdd@gmail.com. Thank you for the energy put into this form.


Sending you light and love on this incredibly honorable journey you are on!

- Nat, founder & CEO of "period"
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電子郵件 *
Name *
Have you been diagnosed or suspect to have PMDD/PME? *
If you had a magic wand that could eliminate any symptom from your luteal phase (the two weeks leading up to your period) what would that be?
What are you hoping to gain from participating in the PMDD Program? *
What kinds of alternative medicine have you tried before, and what has resonated the most with you/ has proven to be the most effective, if any? *
Do you have any questions/concerns about the program? (We can go over these during our 15-minute intro call is scheduled- pending application approval)
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