I can commit to attending a weekly 60-minute live group call for 12 weeks.

I have 30–60 minutes per week for reflection and integration.

I understand this is a coaching container, not therapy or crisis support.

I am financially able to invest in coaching without creating stress or resentment.

What are you hoping will be different in your life after 12 weeks?

What do you feel is costing you the most right now?

Which patterns feel most familiar for you? (Select all that apply)

When I feel overwhelmed, I tend to:

I am willing to take responsibility for my patterns and choices.

I’m open to being coached in real time (being respectfully interrupted if I intellectualize, perform, or avoid).

Regarding group agreements: Please check all that apply:

Why now? Why is this the right time for you?

What would make this program a “yes” for you?

Anything else you want me to know?

Thank you for taking the time to fill out this application and for answering honestly. I look forward to connecting with you further.