Work with Us - Application 
This confidential questionnaire will provide me with key insights into your current goals, challenges + most desired outcomes that help determine priority focal points to cover during your session.

NB: This is not therapy. My zone of genius is in seeing you at your absolute highest potential, and holding you to that, by cutting through bullshit, and skipping right to the heart of the matter at every turn. Its a safe space to move through parts of your life that may hold a strong charge, be it trauma etc helping you find power in that space.

Not all applications are approved for a consult call. There must be 100% alignment. 
* Please check your junk folder and mark/star our email address as VIP and save it in your address book to ensure you receive our communications.

We value your privacy, and all answers are strictly confidential.

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Email *
Cell No. *
Please include Country Code in brackets i.e. (+27)
What Coaching do you want to explore? *
Where did you come across this place? (Frequency Coaching) *
Please Answer All the questions with complete transparency
Be clear, be specific and add as much details as possible.
What is Your Name? *
What is your Surname? *
Where is the best place to contact you? (Whatsapp, Instagram or Facebook?) Leave applicable details, number, link etc. *
Instagram/ Tiktok Tags
Details for Your Human Design Type
This helps me better understand how you work and go about life- if you do not have the information available or would like to discuss this part more on the call - happily todo so.
Date of Birth?
MM
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DD
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YYYY
Time of Birth?
Time
:
Place of Birth?
Are your applicable challenges are you navigating? *
Required
What other relief methods (if any) have you tried to alleviate these issues? (e.g.: Other mindset coaching programs or healing modalities, etc.) *
Are you taking any prescription medications?  *
If you answered YES to above, which prescription medications?
CURRENT BLOCKS & CHALLENGES
In detail, describe the challenges in your life and intimate relationships. How long have you had these issues? How does this affect your everyday life? Be as descriptive as you can.
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What has the above challenge stopped your from creating/manifesting in your life? *
What makes you deeply uncomfortable? Something that brings about a fear-based response. *
What inspires and excites you? Something that brings about a sense of possibility. *
What does a standard day in your life look like? *
What time do you wake up and go to bed? What do you typically do etc, run through this from the beginning to the end of your day.
PRIORITY GOALS: Please share which priority goals or success results you're committed to achieving within the next 90 days (internal and/or external).*
Your answer

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How are you getting in your own way? What do you keep on doing, thinking and actioning that is not serving you? (take your time on this one) *
Which of the following foundations do you need in order to further embody & achieve the goals listed above?
 *
PRIORITY FOCAL POINTS FOR OUR CONVERSATION
Use this space to share what you'd specifically like to focus on during our time together.

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MOST DESIRED OUTCOMES with working together
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