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The Well-Rounded Musliminah Coaching — Coaching Interest Form
(Faith-Based ADHD & Life Coaching for Muslim Women)

Assalamu Alaikum 🌿

Thank you for your interest in The Well-Rounded Musliminah Coaching, a faith-based life coaching service for Muslim women, with a special focus on ADHD-friendly support. This initiative is powered by Yetooudee Alla LLC.

We offer personalized 1-on-1 coaching designed to help Muslim women find focus, structure, and emotional balance, while aligning their daily lives with faith, family, and personal growth.

Please complete this brief form so we can better understand your goals and connect with you to schedule a free discovery session.

📩 All responses are confidential and reviewed with care and respect.

💫 SECTION 1: Personal Information

What is your name?

What is your email address?

Phone Number (optional)

What is your city/state?

Age Range?

A
B
C
D
E

💫 SECTION 2: About You

Which best describes your current stage of life?
Untitled multiple choice field
A
B
C
D
E
F

What feels like your biggest struggle right now?

Which best describes what you’re looking for support with?

A
B
C
D

What feels like your biggest struggle right now?

🧠SECTION 3: Coaching Goals

What would you like to achieve through coaching?

How committed are you to making changes and applying new systems?

A
B
C
D

💫 SECTION 4: Contact Preferences

Preferred way for us to contact you:

A
B
C

When are you usually available for a 15-minute discovery call?

A
B
C
D

💫 SECTION 5: Final Notes

How did you hear about The Well-Rounded Muslimah Coaching?

A
B
C
D
E
F

Is there anything else you’d like to share with our team?

Agreement Checkbox

☑️