Intake Questionnaire

What inspired you to explore this coaching journey at this time in your life?

(Share anything that’s been coming up for you or that you're feeling called to shift.)

What are you currently feeling most stuck, blocked, or disconnected around?

(This could be emotional, energetic, spiritual, or related to a life area like relationships, money, purpose, etc.)

How would your life feel or look different if this transformation happened?

(What do you deeply desire to feel, embody, or experience on the other side of this work?)

Have you worked with a coach, healer, or therapist before?

(If yes, what was supportive or unsupported about that experience?)

On a scale of 1–10, how committed are you to doing the inner work and showing up for yourself right now?

(1 being hesitant and unsure, 10 being fully ready and all in)

What tools, practices, or spiritual modalities (if any) have been meaningful in your healing so far?

(e.g., meditation, reiki, journaling, tarot, astrology, therapy, etc.)

Is there anything I should know about your nervous system, spiritual background, or emotional capacity that would help me support you better?

What drew you to me or this specific program?

(Why this space, now?)

This program is an investment and requires devotion. How committed are you to the 3 month , $1800 investment in your life. (limited time special offer)

Please select form the following

This coaching container integrates spiritual tools and energy-based modalities such as reiki, subconscious work, astrology, tarot, inner child healing, and guided meditations. Are you open to exploring this kind of soul-led approach as part of your transformation journey?

Please select from the following

First Name

Last Name

Email *

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