Application Form
Hello beautiful soul,
If you find yourself here, that means that you are ready for transformation and deep inner work.

Filling out this form will help you gain clarity about your goals and it will help me understand what it is that you want to work on.

Be inspired as you answer the questions :)  There are no right or wrong answers.

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Email *
Today‘s date *
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First and Last Name
 *
Age
 *
Where in the world are you located?
 *
I am interested in the following (select all that apply):
 *
Required
What are your reasons for seeking sessions and/or coaching?
 *
How did you hear about me? If someone referred you, please state their name. *
Select all boxes that apply to you.
 *
Required
What are the 3 biggest challenges right now? *
What are your top 3 goals for the next 3 months?                 *
On a scale 0 to 10, how motivated are you to work with me?  (0 - no motivation at all, 10 - as motivated as I could possibly be) *
No motivation at all
I'm 100% ready and commited to myself, my healing and transformation.
On a scale 0 - 10, how motivated are you in accomplishing your goals? (0 - no motivation at all, 10 - as motivated as I could possibly be)
 *
No motivation at all
I'm 100% ready and commited to myself, my healing and transformation.
What days and times are you available for sessions? (select all that apply) NOTE: All quantum hypnosis sessions start at 10 AM PST. *
Required
I offer different packages. What is your current monthly coaching / session budget?
*
Is there anything else that I should know?
Thank you!
Thank you so much for taking the time to answer the questionnaire. After you are done, please SUBMIT your answers and follow the link to set up your 15-minute Clarity Call.
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