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.

Note: Coaching will ONLY be provided by Nick as Karis is taking time away and focusing on other projects.
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.

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 *
Are you inquiring as a person or entity? *
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? *
Instagram/ Tiktok Tags *
Pronouns *
Where is the best place to contact you? (Whatsapp, Instagram or Facebook?) Leave applicable details, number, link etc. *
Date of Birth? *
MM
/
DD
/
YYYY
Time of Birth? *
Time
:
Place of Birth? *
Are you acting as a reasonable person , clear in body mind and spirit, and Consciously acknowledging your actions?  *
Are your challenges primarily business or personal *
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 currently seeing a Psychotherapist or Psychologist? (YES or NO - Which kind and how long?) *
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 and include any awareness (if any) of childhood trauma that you are comfortable expressing.
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What has the above challenge stopped your from creating/manifesting in your life? *
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? And then why? (take your time on this one) *
Which of the following foundations do you need in order to further embody & achieve the goals listed above?
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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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