Apply for a free consultation
Welcome beautiful soul!

This form is not a commitment. You may use this form to register your interest, and if we are a good fit to work together, you will receive an invitation for a complementary consultation call.

Please set aside 20 minutes to complete this questionnaire. Ensure that you are relaxed and have time to reflect on the questions.
Sign in to Google to save your progress. Learn more
Email *
By filling out this application, you will be considered for a complimentary consultation call to see if we are a good fit to work together. Filling out this form in depth, and in detail, will increase your chances of being considered. *
Required
Let's begin with an easy question. Please share 5 positive adjectives you would use to describe yourself. *
How did you hear about me? What made you excited to work with me on your healing journey? *
What do you currently love about yourself and your life? What is going really well for you right now? *
What are you currently "growing" through? What challenges are you facing and what are you learning to overcome? Take your time with this question. *
I specialize in helping current or aspiring healers, visionaries, coaches, therapists, and "helpers" of the world to heal their own wounds, so that they can embody the purpose and love they are here to live.

Please share with me in your words where you are at in your journey of finding your path and purpose in life. 

In what ways do you feel called to make the world a better place?
 *
How long have you been on this healing/inner growth journey? Have you worked with other therapists, counsellors or coaches? What was that like for you? *
Tell me about your current support system (friends, family, coaches, therapists, etc.) *
What do you deeply desire for yourself and for your life? *
What do you think is holding you back from being the person you truly want to be, and feeling how you truly want to feel?  *
Please share a little bit about your current spiritual practices or journey. Do you have a daily or regular practice? What are your spiritual interests? *
My approach is to empower people to become their own healers. We have all the love we need within ourselves to heal even the darkest of shadows. Healing involves letting go of our wounds so that we can emerge as the happy, loving, and beautiful souls that we truly are. Do you feel ready to commit to your growth and embark on this journey?  *
What would you most look forward to if we were to work together? Select all that apply! *
Required
Please select all healing modalities which you have PREVIOUSLY experienced: *
Required
Please rate your mental wellness over the last year: *
Very challenging or more reliant than usual on external support or resources.
Excellent
Please rate your physical wellness over the last year: *
Very challenging or more reliant than usual on external support or resources.
Excellent
Optional: Please provide any additional info on your last two responses.
I understand that for the safety of her clients, Jennifer will refer individuals who are currently, or have recently experienced, struggles with addiction, abusive relationships, complex trauma, or risk of a mental health crisis, including severe anxiety or depression, to a licensed mental health professional first.

*If you have recently experienced a mental health crisis (within the last year), or if you feel you may be at risk, please check the second box and visit checkpoint.org for resources.
 *
Optional: If you would like to be considered for the next available scholarship, please e-mail me a short composition reflecting upon ONE of the following prompts.

a. Share a personal story about how you overcame a challenging situation in your life.
 
b. Tell me about your spiritual awakening journey, and the ways in which you feel called to help the world in this lifetime.

**Please also include your reasons for needing a scholarship at this time.**

Send to jenn@moonpathwellness.com
Thank you for taking the time to fill out this application! If we are a good fit, you will receive an invitation within a week for a consultation call. 

The purpose of this call is so we can meet and see if we are a good fit for one another, and to answer any questions you may have about my work.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Jennifer Helwing Wellness Coaching. Report Abuse
Google Forms