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Application for the rRest Practitioners Certification Program
We are pleased you are interested in the rRest Practitioners Certification Program. Filling out this application is a valuable exercise in self-reflection and clarity. We would love to have you participate with us to learn this powerful technique if it's a good fit. Filling out this application will support you in the growth of your business and help us get to know you and help us design the program to meet your needs.
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Email
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Your email
What is your first name?
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Your answer
What is your last name?
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Your answer
What is your phone number?
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Your answer
How did you find the rRest Practitioner Training Program?
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Dr. Mitra Ray
Dr. Cindy Sholes
Facebook
Internet Search
Meetup
Friend
Doctor
Other professional
Share with us the name of the person who told you about rRest so we can thank them.
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Your answer
What's your gender?
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Male
Female
Other
How old are you?
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Teenager
20 something
30 something
40 years young
50 years wise
Over 60 years wiser
What is your vision for yourself? Do you see yourself using rRest for yourself, family, friends, current clients, and/or starting a new business?
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Your answer
What holds you back from creating what you desire in your life? What's been your biggest challenge so far in the area of growth for yourself or your business?
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Your answer
Tell us about your background, education, health care license, and/or certification that might relate to using rRest with clients...
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Your answer
Do you currently have a coaching or wellness practice?
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Yes
No
How many clients do you have?
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Your answer
How do you work with your clients?
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Your answer
How much money are you currently making in your business? (this is confidential and is useful in helping us help you reach your income goals)
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Your answer
Adding rRest to your existing practice will accelerate your client's success. You may want to increase your rates or make other changes in how you see clients or your business structure. How do you see rRest integrating into your existing practice?
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Your answer
On a scale of 1-5, how successful have you been enrolling paying clients? (be as honest with yourself as you can)
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5 - I have successfully mastered this skill
4 - I am comfortable with this skill and see room for improvement
3 - I am actively working on improving this skill
2 - I have tried but haven't had much success
1 - I am a complete beginner in this area
On a scale of 1-5, how successful have you been helping your clients get the results they are looking for? (be as honest with yourself as you can)
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5 - I have successfully mastered this skill
4 - I am comfortable with this skill and see room for improvement
3 - I am actively working on improving this skill
2 - I have tried but haven't had much success
1 - I am a complete beginner in this area
On a scale of 1-5, how committed are you to improving your clients results with rRest? (be as honest with yourself as you can)
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5 - I am extremely committed
4 - I am committed
3 - I am somewhat commited
2 - I am struggling to be commited
1 - I am lacking commitment
Would you like to use rRest to generate more income?
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Yes
No
Would you like to change the number of clients you see? Explain.
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Your answer
How much money would you like to make in your business a year from now?
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Your answer
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