1 on 1 Thriving Fearlessly Wellness Coaching Application

Welcome to the Thriving Fearlessly Wellness Coaching program!

Thank you for your interest in working with me. This application is the first step in making sure we’re a great fit to work together on your journey toward living fearlessly—mind, body, and soul.

Please take your time to answer the following questions thoughtfully and honestly. Your responses will help me understand your wellness goals, current challenges, and how I can best support you with compassion and clarity.

Remember, this is all about you—your story, your healing, and your vision for a vibrant, thriving life.

Name

First Name

Last Name

Phone

(###)

###

####

How are you feeling in your life right now—physically, emotionally, and energetically?

(Be as honest and detailed as you’d like.)

What are 3 areas you’re hoping to shift, heal, or grow through coaching?

What does “thriving” look or feel like for you in this season of life?

What are some of the biggest challenges or barriers you’re currently navigating?

(This could include health, mindset, time, overwhelm, etc.)

Have you worked with a coach, therapist, or wellness practitioner before?

(If so, what worked—or didn’t—for you?)

What kind of support do you feel you need most right now?

Examples: accountability, emotional validation, mindset tools, nervous system support, clarity on next steps…)

This is a personalized, intentional coaching experience. Are you open to gentle but honest reflection and trying new approaches?

Do you have any chronic conditions, health concerns, or access needs you’d like me to be aware of as we work together?

Is there anything else you’d like me to know about you before we connect?

1 on 1 Thriving Fearlessly Wellness Coaching Application

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