Application - Chaos To Calm Group

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This is a "fee-for-service" group considered a valuable investment in your transformation. It’s important to make sure that you and the group are a great fit for each other. There are two levels to discern that. (1) All prospects fill out an initial application. (2) Then I'll call and we'll schedule a 20 minute virtual meeting.

If the group is already full, we'll add you to the waiting list. Or we'll talk through your options.

Email *

Name *

First and last name

Are you a current or previous client? *

Yes, I'm currently seeing you for counseling or consulting

Yes, I'm a previous client and have seen you in the past

Other:

Fee for the six-week "From Chaos to Calm" Group is $697 paid in advance. Knowing this, are you able to invest in your transformation at this time? *

Yes

Maybe

What kind of support do you have now? *

What would you like to get from being in the "Chaos to Calm" group? *

Support - I'm too isolated with all the changes I'm going through

I need help with doing the next right thing

I need skills and accountability i.e. assertiveness, confidence, communication

I need clarity and sense of purpose

All of the above

Other:

Required

What do you think transformation would look like for you after completing six weeks of group experiences?

What are the biggest obstacles you face with a six-week commitment toward nurturing your true self?

How crucial is this transformational opportunity for you now? *

I'm so unsure at this point.

I'm whole-heartedly committed to taking risks of growth. This group is exactly what I need right now.

What draws you to the group at this time? *

If you and I could sit down and visit with a cup of tea or coffee, what would you like to share?

What is the best way to contact you? (please include phone number) *

Send me a copy of my responses.

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