Company Name
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Website
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First Name
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Last Name
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Phone
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Email
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What’s been going on in your team or organization that led you here?
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When you think about stress at work, which of these feels most true right now?
Stress is definitely impacting communication and decision-making
We notice burnout, but we haven’t connected it to performance directly
It comes up in moments, but we don’t have a shared language for it
We’ve started exploring nervous system / regulation concepts
I’m not sure yet, but I’m curious
If things were working really well, what would feel different day-to-day?
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What have you already tried to support your team with this?
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Where are you in your timeline with this kind of work?
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Just starting to explore
Actively looking for the right fit
Hoping to begin in the next 1–3 months
Ready to move forward soon
Do you have a general budget in mind for this type of support?
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Not yet
Under $5,000
$5,000–$15,000
Additional Notes / Context?
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