Page 1 of 7

Personalized 1:1 Emotional Well-being Support

1:1 Programme Application

Thank you for your interest in Personalized 1:1 Emotional Well-being Support, an eight-week private emotional-awareness and self-connection journey offered through Untangle Emotions.

This programme uses guided reflection, therapeutic-art practices and coaching conversations to help you understand what you are experiencing, express what may be difficult to put into words and develop supportive practices for everyday life.

No artistic experience is required.

Please complete this form honestly. Your responses will help me understand whether this programme is appropriate for your present needs.

Completing this form does not automatically confirm your place. If the programme appears suitable, you will be invited for a short suitability conversation.


The programme includes:

• Eight private 60-minute Zoom sessions
• One session per week
• Personalised creative and reflective practices
• Simple between-session exercises
• One structured WhatsApp check-in each week
• A closing review and 30-day continuation plan

Founding programme fee:

₹15,000 when paid in full
or
₹8,000 + ₹8,000 in two instalments

Basic Information

Full Name

Age

City and country

WhatsApp Number

Email

How did you hear about Untangle Emotions?

A
B
C
D
E
F
G
H
I