Application Form: Conscious Healing Blueprint (2022)
Hello beautiful soul! Thank you for your interest in Conscious Healing Blueprint!

CHB is a 3-month group program for women with chronic health issues who are ready to step into their power, connect to their highest self and their truth, release all that is standing in the way of their healing, and heal from within.

The program includes online & group teachings, trainings, healings, activations (with a Gold Level upgrade option of 1:1 coaching and guidance).
For full specifications of the program, go to https://pavlinajirouskova.com/conscious-healing-blueprint/

Take your time to complete this application thoughtfully and with intention.

This is how the process will work:

1) Apply for Conscious Healing Blueprint using this form. Applications deadline has been extended until Friday, 21st January 2022

2) If accepted, you will be notified per email and required to pay in advance, either in full or one monthly deposit to hold your spot (depending which payment option you choose). Program cost is one time payment of $2'222 or three monthly payments of $777.

3) Option to apply for Gold Level upgrade & have my 1:1 support during the program. If accepted, you will be notified per email and invited to an application call to connect on a personal level and to both see if it's a fit for you.
**1:1 places are limited & the cost of the upgrade is a total of $4'444, (or three payments of $1'555). To apply for the Gold Level upgrade please select the "yes" option at the bottom of the application form**

Please note: Completing this application (and scheduling a call) does not obligate you to join the program or guarantee you a spot. It’s simply the steps in exploring this option for us, together. However, only apply if you're seriously interested in this container of healing and transformation.

With love,
Pavlina
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Please confirm your application by checking the box *
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Your Full Name *
Your Email Address *
Your Time Zone / Where are you in the world *
Please tell me about why you would like to join Conscious Healing Blueprint. *
What are you currently struggling with? Is there anything that you feel is standing in the way of your health and wellbeing? *
What would you like to achieve during our time together? *
Are you ready to dedicate your time and energy towards your healing, growth, and expansion for the duration of the program? *
Anything else I should know? *
Did anyone refer you to the program (if so, please say who)? Or how did you find out about it? *
Would you like to apply for the Gold Level upgrade option & have my 1:1 support during the program? **Gold Level places are limited & the cost of the program is higher ($4'444). If you select the "yes" option, you will be invited to an application call** *
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