Apply for your free coaching session! ↓

This is for a genuine coaching session, not a sales call. You'll leave with insights and a tool you can use tomorrow.

During your 90-minute coaching session you'll:

Feel genuinely seen and understood in your leadership context
Understand your dominant stress response as a leader
Have clarity on what is secretly driving your burnout
Know your personal asset for burnout protection
Have a technique you can use immediately
Understand what deeper work together could unlock
Feel zero pressure, just genuine support

This brief application helps me determine if we're a good fit to work together. Please answer honestly - your responses will be treated with strict confidentiality.

First Name *

Last Name *

Email *

Phone

Current role and company *

LinkedIn profile (optional)

Your leadership situation

1. What's your biggest leadership challenge right now? (One specific challenge - e.g., "reactive decision-making during crisis situations") *

2. What outcome would make this coaching worthwhile? (What needs to change for this to be a success?) *

3. How long have you been experiencing this challenge? *

Less than 6 months

6-12 months

1-2 years

2+ years

5. Anything else you might have tried and what was your experience?

Your current stress pattern

6. Which best describes your typical stress response? *

Anxious/Activated: I get on edge, controlling, urgent. Trouble slowing down or relaxing.

Shut down/Numb: I avoid things, procrastinate, feel disconnected and exhausted.

Both: I swing between anxious and shut down.

Not sure

6. Rate your current state: Energy Level (1=exhausted, 5=energised) *

Very lowExcellent

7. Rate your current state: Stress Level: (1=manageable, 5=overwhelming) *

Very lowVery high

What else might be affecting your leadership?

Readiness and commitment

9. How ready are you to invest in personal transformation? (1-5) *

ExploringStart ASAP

10. Can you commit 10-15 minutes daily for practices between sessions? *

Yes, absolutely

Yes, but challenging

No, too busy

Not sure

11. Which describes you best? *

Ready to do the work: I'll practice daily and fully engage. I know I need to do the work, not just receive it.

Willing to try: I'm interested but have limited time. I need techniques that fit my schedule.

Still exploring: Not sure if this is right. Want to learn more before committing.

Need quick results: I need immediate results without much effort on my part.

Mental wellbeing (answers strictly confidential)

12. How would you describe your current functioning? *

Stable: Functioning well, want to optimise performance

Challenged but functional: Struggling but managing work and life

Significantly impacted: Mental wellbeing notably affecting work ability

In crisis/ full burnout: Immediate clinical intervention needed

Program & investment

13. If you continue with coaching, would you like official documentation and invoicing for company sponsorship?

Yes please.

Not needed, thank you.

Not sure yet

14. How soon would do you want to start? *

Immediately (1-2 weeks)

Within a month

2-3 months

Just exploring

If other or referral please specify:

Final questions

16. What's your biggest concern about starting this coaching partnership?

17. Is there anything else I should know?

Understanding & consent

Please check ALL boxes: *

I understand coaching is not therapy or medical treatment1

I'm responsible for implementing techniques and creating results

The first coaching session is FREE without future obligation either side

I am happy to receive an email to book the session

What happens next?

If we're a good fit, you'll receive within 1-2 business days:

A calendar booking link to arrange your FREE, 90 minute coaching session at your convenience
Or a waitlist notification if I'm at capacity
Please monitor all email folders (set support@innergised.life as safe sender)