Regain Your Core® Coaching Application

Thank you for your interest in the Regain Your Core Coaching Program

This application helps determine whether this coaching experience is aligned with what you’re seeking now.

Some questions ask about your mental health history and current support. These questions help clarify whether this coaching space is a supportive fit at this time, or whether a different level of support may be more appropriate.

Please answer each question honestly. Your privacy is respected, and the information you share will be handled with care and confidentiality.

If additional clarification is helpful, Dr. Novia will contact you using the information provided.

Session Availability: Coaching sessions are held weekly on Tuesdays or Wednesdays between 11 AM & 2 PM EST. Before applying, please make sure this time window works for your schedule. If you are invited into the program, your assigned session day and time will be emailed to you before the program begins. Note: Sessions are live and replays are not provided.

Click Start to begin your application.

Start

Question 1 of 16

Full Name

Paragraph answer

Question 2 of 16

Email Address

Paragraph answer

Question 3 of 16

Best Telephone Number

Paragraph answer

Question 4 of 16

Which Regain Your Core program are you applying for?

A

Group Coaching

B

One-to-One Coaching

Question 5 of 16

Tell me about where you are right now.
In your own words, what feels most important to you at this time of your life, and how do you want to feel more aligned with yourself?

Paragraph answer

Question 6 of 16

If we were 4 months into the future and Regain Your Core had been meaningful for you, what difference would you notice?
Consider your sense of self, your relationships, and your day-to-day life.

Paragraph answer

Question 7 of 16

What gives you hope that change is possible for you at this time?

Paragraph answer

Question 8 of 16

What has been helpful for you in the past to support your personal growth journey? For example: therapy, books, courses, coaching, retreats.

Paragraph answer

Question 9 of 16

Are you currently working with a psychiatrist, therapist, or counselor for any mental health concerns?

A

Yes

B

Not currently, but I have in the past

C

No

Question 10 of 16

Are you currently diagnosed with a mental health condition? For example: anxiety, depression, PTSD, bipolar disorder, or another diagnosis.

A

No

B

Yes

C

I’m not sure

Question 11 of 16

Within the past two years, have you experienced thoughts of self-harm or suicide, engaged in self-harm, or attempted suicide?

A

No, I haven’t

B

Yes, I have

Question 12 of 16

Are you currently experiencing thoughts of suicide or self-harm?

If you are currently in crisis, feel unsafe, or may be at risk for harming yourself or someone else, please contact emergency services or a crisis support line now. This application is not monitored as crisis support.

A

No

B

Yes

Question 13 of 16

Regain Your Core is focused on personal growth. It is not therapy, mental health treatment, or crisis support, and is not intended to replace therapy, psychiatry, or medical care. Based on this, which statement is true for you right now?

A

I understand, and this feels like the right kind of support for me

B

I’m not sure if this is the right level of support for me

C

I’m currently needing a higher level of support, such as therapy, psychiatry, or crisis care

Question 14 of 16

Are you able to show up and fully engage and participate for the duration of the program?

A

Yes

B

No

C

I’m not sure

Question 15 of 16

If you are invited into the coaching program, are you financially prepared to make the investment at this time? Please review the investment before answering. The investment for both programs are accessible through the Offerings page, including the Learn more about one-to-one coaching link.

A

Yes, I’m prepared to make the investment

B

Possibly, I would need to consider my finances and available resources

C

No, I’m not in a position to make this investment right now

Question 16 of 16

Is there anything else you’d like to share or you think would be helpful to know?

Paragraph answer

Confirm and Submit

Name

Email

Subscribe to our email list

Regain Your Core® Coaching Application

Click Start to begin your application.

Full Name

Email Address

Best Telephone Number

Which Regain Your Core program are you applying for?

Tell me about where you are right now.In your own words, what feels most important to you at this time of your life, and how do you want to feel more aligned with yourself?

If we were 4 months into the future and Regain Your Core had been meaningful for you, what difference would you notice?Consider your sense of self, your relationships, and your day-to-day life.

What gives you hope that change is possible for you at this time?

What has been helpful for you in the past to support your personal growth journey? For example: therapy, books, courses, coaching, retreats.

Are you currently working with a psychiatrist, therapist, or counselor for any mental health concerns?

Are you currently diagnosed with a mental health condition? For example: anxiety, depression, PTSD, bipolar disorder, or another diagnosis.

Within the past two years, have you experienced thoughts of self-harm or suicide, engaged in self-harm, or attempted suicide?

Are you currently experiencing thoughts of suicide or self-harm? If you are currently in crisis, feel unsafe, or may be at risk for harming yourself or someone else, please contact emergency services or a crisis support line now. This application is not monitored as crisis support.

Regain Your Core is focused on personal growth. It is not therapy, mental health treatment, or crisis support, and is not intended to replace therapy, psychiatry, or medical care. Based on this, which statement is true for you right now?

Are you able to show up and fully engage and participate for the duration of the program?

If you are invited into the coaching program, are you financially prepared to make the investment at this time? Please review the investment before answering. The investment for both programs are accessible through the Offerings page, including the Learn more about one-to-one coaching link.

Is there anything else you’d like to share or you think would be helpful to know?

Confirm and Submit

Tell me about where you are right now.
In your own words, what feels most important to you at this time of your life, and how do you want to feel more aligned with yourself?

If we were 4 months into the future and Regain Your Core had been meaningful for you, what difference would you notice?
Consider your sense of self, your relationships, and your day-to-day life.

Are you currently experiencing thoughts of suicide or self-harm?

If you are currently in crisis, feel unsafe, or may be at risk for harming yourself or someone else, please contact emergency services or a crisis support line now. This application is not monitored as crisis support.