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1:1 Coaching Application
This application is for people who are serious about making a change. Fill this out honestly, and I’ll reach out to you on Instagram if you’re a good fit.
What's your name?
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Age?
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Which of these do you struggle with? (pick all that apply)
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Which of these do you struggle with? (pick all that apply)
Anxiety in relationships (overthinking, jealousy, fear of losing people)
Emotional reactions I can't control (anger, shutting down, spiraling)
Patterns I keep repeating no matter who I'm with
Avoidance (pushing people away, struggling to open up)
A recent breakup or relationship I'm still not over
Tell me more about what's going on. What does it look like day to day? (be specific + detailed)
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What would your relationships and emotional life look like if you actually took the steps to fix this permanently?
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If nothing changes, where do you see yourself in a year? (be honest)
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Are you currently employed?
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Are you currently employed?
A
Yes
B
No
Where did you find my videos?
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Where did you find my videos?
A
Instagram
B
Tiktok
Phone number
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Email address
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My coaching is a paid service and requires a meaningful financial investment. If we decide to work together once I reach out to you, what are you comfortable investing
monthly
?
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My coaching is a paid service and requires a meaningful financial investment. If we decide to work together once I reach out to you, what are you comfortable investing monthly?
A
Under $200
B
$200-400
C
$400+
Submit