Please complete the application below in its entirety to be considered for coaching.

The Awakened Coaching Program

First name

Last name

Phone

What inspired you to explore this coaching program?

What are your top three personal goals you want to achieve through coaching?

What specific challenges or obstacles are currently holding you back?

What excites you most about the possibility of working with me?

Have you experienced significant emotional or spiritual trauma?

Yes

If yes, can you briefly describe your experience (only as much as you are comfortable sharing)?

Are you currently working with a therapist, counselor, or other mental health professional?

Yes

If yes, how does coaching complement your current mental health support?

How would you rate your readiness for change on a scale from 1 to 10 (1 = not ready, 10 = fully ready)?

What steps have you already taken toward personal growth and healing?

What concerns or hesitations do you have about joining this program?

How would you describe your spiritual beliefs or practices, if any?

Is there anything else you would like me to know about you or your journey?

Should you be offered the opportunity to meet with with Dr. TSA Series, do you commit to showing up for your call or notifying us beforehand if you need to reschedule?

Yes