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PREET K. BRAR
Reset & Flourish Group Coaching Application
This short form helps us understand where you're at and whether the Reset & Flourish coaching program is the right next step for you.
Please answer honestly. Your responses are confidential.
What is you full name?
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Age
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Where are you located?
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Profession/Work Role
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Email Address
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Phone Number
Which stage best describes where you are right now? (Choose the one that feels closest.)
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Which stage best describes where you are right now? (Choose the one that feels closest.)
A
I haven’t had a period in over 12 months — I believe I’m in menopause
B
My periods are irregular or shifting — I think I’m in perimenopause
C
I still have regular periods, but I’m noticing mood, energy, or body changes — maybe early perimenopause?
D
I’m not sure — I just know something feels off
E
None of the above
Which of the following are showing up most often in your day- to -day life? (Select 3 or more that feel true for you)
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Which of the following are showing up most often in your day- to -day life? (Select 3 or more that feel true for you)
I feel foggy or forgetful, especially at work
I’m more irritable, anxious, or emotionally reactive than I used to be
I often feel exhausted — even after resting
My libido has dropped or intimacy feels different
Lack of Confidence or don't feel like myself anymore
Always feeling hot and sweating even in AC
I’m gaining weight or feel inflamed, even with no change in diet
I’m not sleeping well or wake up tired
I keep powering through, but I know something’s off
I’m managing fine — just curious about menopause
How are these changes affecting your confidence, energy, or relationships? (Choose all that apply.)
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How are these changes affecting your confidence, energy, or relationships? (Choose all that apply.)
I’m showing up at work, but I don’t feel sharp or confident anymore
My mood shifts are straining my marriage or close relationships
I’ve started avoiding social or professional opportunities
I feel emotionally flat — like I’ve lost my spark
I feel alone in this, and no one really gets it
I’ve been managing fine — it’s uncomfortable, but not affecting my life deeply
What have you already tried to feel better (Select all that apply.)
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What have you already tried to feel better (Select all that apply.)
Supplements or Ayurveda
Medical help
Therapy or self-help
Ignoring it and pushing through
Researching on YouTube/Instagram
Nothing yet — I just kept quiet
What would you love to feel 3 months from now?
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What would you love to feel 3 months from now?
A
Clear-headed and confident again
B
Calmer and more emotionally steady
C
Reconnected to my body and energy
D
More visible and in control of my life
E
I’m not sure yet — but something has to shift
Are you open to starting coaching with in the next 2 weeks if accepted?
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Are you open to starting coaching with in the next 2 weeks if accepted?
A
Yes, I'm ready
B
No, I'm exploring for later
This is a premium group coaching experience (₹85,000 INR). Is this within your current comfort?
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This is a premium group coaching experience (₹85,000 INR). Is this within your current comfort?
A
Yes, I’m ready to invest in myself
B
I’d need a payment plan
C
No, this isn’t in my range right now
Submit