top of page
First name
Last name
Email
1. Tell me a little about you. Who are you beneath the heartbreak? How would you describe yourself right now in this chapter of life?
2. What led you here? Are you moving through a breakup, divorce, betrayal, or another form of heartbreak? What’s been the most difficult part for you?
3. How is this experience impacting the way you see yourself? What stories are you telling yourself right now about your worth, your future, or your ability to trust again?
4. What kind of woman do you want to become on the other side of this? Describe the version of you you’re trying to come home to — even if she feels far away right now.
5. Have you done any inner work before — therapy, coaching, spiritual practices, journaling, etc.? If yes, what helped you? If no, that’s okay too. Just share honestly where you’re at.
6. What patterns or beliefs do you feel are keeping you stuck? Be real with me — what keeps circling back in your healing, relationships, or self-talk?
7. Are you ready to invest in yourself — financially, emotionally, and energetically? This work will ask you to show up for yourself in ways that may feel new or uncomfortable. Are you open and willing to do that?
Yes, I’m ready to go all in
I want to, but I’m scared — and I’m willing to be supported through it
I’m not sure yet
8. What kind of support do you feel you need right now? Do you feel called to 1:1 guidance, community healing, or something else? There’s no wrong answer — just what feels most nourishing.
9. Why now? What made you apply at this particular moment? What shifted or clicked for you?
10. Is there anything else on your heart you want to share with me? This is your safe space — say anything you need to.
Submit
bottom of page
