Transformational Shift Mentorship Application

Thank you for your interest in the Transformational Shift Mentorship! Please fill out the form below and I will respond within 1-2 business days.

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Email *
Client Full Name *
Email *

Are you currently receiving any mental health services? If so, please elaborate.

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Are you under the care of a physician for any chronic illness. If so, please explain.
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Are you currently taking any mood/behavior altering prescription medications?
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What is calling you to work with me?

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What are your top goals from having a session with me?

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What do you want to change about your current situation?

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What would this change mean for you in your life?

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