1:1 Coaching // Interest Form

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Email *

What's your name? *

What are you currently most excited about? *

What are the habits and beliefs you'd most like to change? *

Please share what, if any, coaching or personal development work you've done in the last 2 years. *

How do you see/think I could most help you? Please be as specific and thorough as possible. *

Are you interested in business coaching? *

Clients work with me for a variety of reasons. Which ones would you most like to explore together? Select all that apply. *

Life transition support (leaving/starting new career, empty nester, etc)

Brain retraining and unconscious mind coaching

Somatic practices and nervous system regulation

Defining your soul values and living them day-to-day

Boundaries and clear communication

Tools for living with a higher sense of fulfillment + joy

Implementing new wellness practices into your life

Other:

Required

What is your level of readiness to hire me as a coach? *

The investment for this container and this level of support starts at $6,000 for 4 months together (or $4,000 for sliding scale). Are you ready to say yes to this? Is this investment something you are comfortable with and confident about being able to fulfill? *

Yes! This feels so aligned for me and I can commit (select this option for both full price and sliding scale)

This investment feels like a push for me, and I am willing to prioritize the cost. Let's do a payment plan!

No, this is out of my budget for the time being.

Is there anything else you want me to know? *

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