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Regain Your Core Application

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What is motivating you to complete this application today?

Identify the main problem (s) you're experiencing at this time.

What is most challenging to you?

How long have you been experiencing the problem (s)?

What solutions have you tried in the past, and what was the outcome?

Have you ever been under the care of a therapist or psychiatrist? If yes, when and what are/were you being treated for?

Have you been hospitalized for mental health reasons in the past 12 months? If yes, please explain.

Have you experienced suicidal thoughts or tried to harm yourself in the past 12 months?

What is your desired outcome from the Regain Your Core coaching program?

How would life be different if you achieved your desired outcome?

What’s the barrier to achieving your desired outcome on your own?

Please share why achieving your desired outcome is important at this time versus six months from now.

Do you have the financial resources to invest in the program?

If accepted into the program, how soon are you ready to begin?

Which program are you applying for?

We appreciate your interest in the Regain Your Core coaching program. We will review your application, and you should receive an email response within 72 hours. Thank you for applying!

Regain Your Core Application

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Regain Your Core Application

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