Coaching Questionnaire

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Email *

Name *

Where do you live? *

Please tell me what you do for a living, if applicable. *

What is your Instagram and/or website? *

Have you invested in coaching before? If yes, please tell me what it was like for you. *

Please list three things you'd like to change about your life. *

If the things listed in the last question were to shift in the way you want them to, how would your life be different? *

How would you rate the health of your boundaries? *

I have horrible boundaries and often feel like I am bleeding out energy and trying to make everyone happy.

I have great boundaries and feel comfortable knowing how/when to set them.

Why do you want to work with me? *

This work will require you to set aside time for contemplation, practice, and writing every week. How do you plan to make space in your current life to honor this container? *

How well do you trust yourself? *

I don't trust myself or my decisions at all.

I trust myself completely.

There are currently three options for coaching with me:

1) A 3-month coaching container with weekly sessions and support via WhatsApp or Telegram in between sessions. $2800. (These packages are limited and this option will be removed once they are filled for April 2023.)

2) A 6-month immersion with weekly sessions, access to me via WhatsApp or Telegram between sessions, and discounted retreat and program work. These immersions are a four-figure investment.

3) A one-year immersion with weekly sessions, access to me via WhatsApp or Telegram in between sessions, discounted retreat and program work, and a private 1:1 retreat halfway through our container. These immersions are a five-figure investment.

Which one calls to you the most?

3-Month Container

6-Month Container

One Year Container

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms