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CLARITY by Design Application Form

CONGRATULATIONS on taking the first step toward your commitment to change!
CLARITY by Design is a 12-session group program that is designed for women who are ready to better understand themselves more deeply, explore the patterns shaping their lives, and create greater clarity for what they want to experience next.
Applications are used to ensure all participants are aligned with the overall objective of the program. Upon review of your application I will reach out to schedule a 30-minute call to discuss program registration options, or to provide information for alternate options if they are better suited to your objectives.
Please answer all of the following questions. If any of the questions are challenging to answer simply respond with 'unclear'.

Tell me a little about yourself.

1. What feels important for me to know about you at this stage in your life?

2. What inspired you to explore Clarity by Design?

3. What area(s) of your life feels most unclear right now?

3. What area(s) of your life feels most unclear right now?

4. What patterns, challenges, or questions keep showing up in your life?

5. If you could gain clarity around one thing during this experience, what would you choose?

6. What do you hope will be different after the 12 session program?

7. Have you previously explored any of the following? Check all that apply.

7. Have you previously explored any of the following? Check all that apply.

8. What level of commitment are you able to bring to this experience?

8. What level of commitment are you able to bring to this experience?
A
B
C

9. Is there anything else you'd like me to know?

9. Would you like to explore options to do this work privately in a 1:1 setting instead?

9. Would you like to explore options to do this work privately in a 1:1 setting instead?
A
B

Please provide your contact information.

What is your current occupation?

What country do you live in?