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Name
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First
Last
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What has shifted in your life that makes this moment different from all the times you’ve considered change before?
How long has this been present in your life?
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this What you
What are you currently doing to manage or cope with this?
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What works temporarily? What clearly does not?
Where do you feel this issue most in your body when it activates?
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What is the actual cost of continuing to manage this survival identity for another twelve months?
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(Personally, relationally, financially, or emotionally.)
The investment for this partnership is $4,333. This requires financial, emotional, and psychological commitment.
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Yes, I am committed and ready to schedule
I am ready, but I have logistical questions
I am exploring and not yet committed
If selected, are you available for a 15-minute alignment call to confirm fit and next steps?
Yes
No
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