Hey, beautiful!
I'm thrilled that you're interested in becoming one of my rockstar Self-Love Coaching clients! I want to make sure that we're a solid fit to work together & that my skills are well suited to your struggles, so please complete the following questions for me and then hit the 'submit' button.  You'll hear back from me personally within 1 business day.
let's do this!
What is your full name? *

What is your age? *

Where are you located? *

Why are you feeling called to work with me? *

Have you ever invested in a coach or therapist before? This can include coaching/therapy for non-body related issues, such as depression or anxiety. *

If 'yes', please tell me what your experience was like.
If nothing were off limits, what huge life shift would you want to see happen within you (externally and internally)? *

What do you see as the biggest challenge that you face in regards to your body image and/or self-esteem? *

Are you currently active in any attempts to alter your physical appearance? *

This includes dieting, plans for cosmetic surgery etc.
When was the last time that you felt really great about yourself? *

What are you most hoping that my coaching will help you be able to achieve? *

How much time are you able to dedicate to self-improvement each week? *

On a scale from 1-10 how committed are you to putting in the time, focus, and attention that’s necessary to make the life YOU WANT become reality? *

Please click the button below to submit your answers.

Thank you for your time and honesty today - and let me just say, I applaud your courage in reaching out for help. I'll personally reply to you within 1 business day to assess whether we're a good fit to work together, and we can discuss next steps, options and action points from there.
Thanks for completing this typeform
Now create your own — it's free, easy, & beautiful
Create a <strong>typeform</strong>
Powered by Typeform