Heal to Create Mentorship Application

First Name *

Last Name *

Social Media Handle

Email *

Where are you currently in your business *

Briefly describe your offer, who do you serve, why is it valuable & what is the price point? *

Why does this work light up your soul? I want to feel your heart. Tell me why your work ignites it. *

What area of your life/business are you most looking forward to receiving coaching on + support on? *

What current pattern do you currently struggle with the most? *

What usually triggers that pattern? *

How do you see our offerings helping you reach your goals? *

Do you have morning or evening routines that help you stay grounded or focused? Describe them and their consistency. *

How do you currently plan or structure your days/weeks? How does this impact your consistency? *

What happens in your body when you’re about to take decisive action? *

What do you believe is standing in the way between you and your dream becoming a reality?

What have you already tried to change this and why do you believe it hasn’t fully worked? *

If Heal to Create works exactly as intended, what would be different in your as 6–12 months from now? *

Why now? Why is change so important to you at this moment?

Heal to Create includes weekly 1:1 x 60-minute sessions designed for deep, consistent work. This is not a passive container. It requires commitment, self-responsibility, and openness to being challenged in service of your growth. Are you ready to show up fully, be held accountable, and engage this process with integrity? *

Are you willing and able to make this commitment at this time?

Yes, I’m ready to fully commit and show up consistently
No, this level of commitment doesn’t feel aligned for me right now
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Tuition for Heal to Create is $3,000 for 3 months or $6,000 for 6 months (Paid in Full). Monthly payment plans are available. *

How willing are you to invest into yourself and your dreams right now?

I am able to invest and I am 100% all in
Yes, and I'd love a payment plan
I do not have the ability to invest at this time but I'd love to stay up to date with emails
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If you're accepted, which payment option do you prefer? *

Which payment option do you prefer?

Pay in Full $3,000 for 3 months
Pay in Full $6,000 for 6 months
Monthly payments for 3 months: $1,050 per month
Monthly payments for 6 months: $1,050 per month
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Please provide us with any additional information you think we should know about you or your business