Application for Coaching

Discover Discomfort

Our journey together will be personalized, so be as specific as possible.

First Name *

Last Name *

Phone *

Email *

Instagram Handle

Which of the following best describes your current goals/challenges? (select all that apply) *

I need clarity with my job.

I want to apply different modalities to help me be more present and grateful.

I want to improve my relationship with my spouse.

I struggle with what matters the most. My priorities are not where I want them to be.

I need more accountability.

I feel completely lost and hopeless.

I act and react with emotion when making decisions.

I struggle with morning routines.

I feel lazy.

I feel like I'm not heard. I'm just here to provide.

I struggle with self worth.

Which best describes your physical fitness level? *

Have you been diagnosed with a mental illness? *

What is it you are looking to gain from having a coach? *

What is the biggest hurdle you're struggling with? *

What is your commitment level to your growth? *

1. I’m extremely committed. I’m sick of my own bullshit, and I will do whatever it takes.

2. I’m committed enough to invest in my goals but I’m afraid of what my friends will think.

3. I know I need help to make a change but I’m not sure if I’m ready to fully commit.

Anything else you'd like to add before booking? *