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Regain Your Core® Coaching Application

Thank You for Your Interest in the Regain Your Core® Coaching Program!

This application is an important step that includes several questions to help us determine if we’re the best fit to support you on your journey. Please take your time to complete the application accurately and thoroughly. We deeply value your privacy, and the information shared will be handled with care and confidentiality.

If we require additional details, we’ll contact you using the information you provide. Kindly note that incomplete applications do not receive a response.

🕒 Weekly coaching sessions take place on Tuesday, Wednesday, or Thursday between 11 AM–2 PM EST. Before applying, please ensure this window aligns with your availability. If your application is accepted, you’ll receive your specific session day and time upon enrollment. We’re excited to review your application and hope to work with you! Please check your spam/junk folders for application responses.

🌿 Applications are open through December 28, 2025. Programs begin January 6, 2026.

Start

Question 1 of 11

First & Last Name

Question 2 of 11

Telephone

Question 3 of 11

What do you hope to gain from our work together in the Regain Your Core® Coaching Program and why is this important to you right now?

Question 4 of 11

Please share why you believe Regain Your Core® is a good fit for you at this point in your journey. 

Question 5 of 11

What are the main challenges you’re currently facing? 

Question 6 of 11

What strengths, skills, traits, and support systems (e.g., spouse, trusted friend, church, or community) do you have to help you navigate and overcome your current challenges?

Question 7 of 11

Are you currently diagnosed with a severe mental health illness, which includes but is not limited to bipolar disorder, major depression, or post-traumatic stress disorder (PTSD)?

Question 8 of 11

In the past year, have you experienced thoughts of self-harm or suicide, or engaged in self-harm?

Question 9 of 11

Are you currently working with a therapist, counselor, or psychiatrist?

Question 10 of 11

Is there any additional information you'd like to share with us?

Question 11 of 11

Please specify the program you’re applying for. 

A

Group Coaching (Regain Your Core Tribe)

B

One-to-One Coaching

Confirm and Submit