Apply for Coaching – minervahspace.com

Basic Information

Your Name *

Your Email Address *

Your Phone Number *

Where do you currently live (city/country)? *

Your Age *

Do you have any physical limitations or health conditions I should know about? *

Have you given birth? If yes, how many times and how long ago? *

Your Current State

How would you describe your current physical and emotional state in one or two sentences? *

Do you often feel safe in your body and emotions, or is this something you are learning to rebuild? *

Your Main Challenge

Please describe in depth the issue or challenge you are currently experiencing. * (Take your time, write freely - the more detail, the better I can understand and support you.)

How is this issue affecting your daily life, relationships, or confidence? *

Your Expectations

Why do you feel drawn to work with me specifically? *

What do you hope to receive from this coaching program? *

How do you feel I can best help you? *

Practical

Are you ready to commit to 3 sessions (1 hour each)? *

Which times/days generally work best for you? *

Basic Information

Your Current State

Your Main Challenge

Your Expectations

Practical

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