Full Name

Email *

Which social media platform did we connect on?

Instagram

Facebook

What is your social media handle (so that I can connect with you easier?)

What are your primary health and wellness goals right now? (select all that apply)

Learn more about health and wellness topics

Understand and regulate my nervous system better

Gain a deeper understanding of trauma-informed movement

Improve my stress management skills

Build a personalized wellness plan

Join a supportive community for encouragement and accountability

What best describes your current challenges? (Select all that apply)

Fatigue or lack of energy

Stress or difficulty managing emotions

Chronic pain or physical discomfort

Overwhelm or difficulty with focus

Feeling disconnected or stuck

None of the above; I just want to enhance my overall well-being

Other (Please specify):

How do you prefer to learn about health and wellness? (Select one)

Reading eBooks and self-study materials at my own pace

Attending workshops on specific topics with guided resources

Participating in a comprehensive course with certification

Do you enjoy exploring health topics in a structured, step-by-step program?

Yes, I prefer a structured program with guidance and tools.

No, I like to explore topics independently or in small chunks.

Are you interested in earning a certification in trauma-informed movement?

Yes, I’d like to gain expertise and a certification.

No, I’m just looking for personal growth and wellness tools.

Do you feel you would benefit from personalized, one-on-one coaching?

Yes, I need tailored support and accountability.

No, I’m comfortable with more general guidance.

Do you prefer working within a supportive group or community?

Yes, I enjoy learning and growing alongside others.

No, I prefer to work on my own.

How much structure and guidance do you need in managing stress and creating balance?

High: I’d like clear direction and support from a coach or instructor.

Medium: I like some structure but also value flexibility.

Low: I prefer to explore and experiment at my own pace.

Which ONE of these statements best resonates with you? (at this time)

I’m new to these concepts and would like to start with basic resources (eBooks).

I’d like a mix of learning and community engagement (Workshops).

I’m ready for an intensive, transformative journey (Rethink Wellness Academy).

I prefer a self-paced, flexible program (Restoring Balance).

I thrive in collaborative environments with ongoing guidance (Inner Circle).

I’d like one-on-one support to address my specific needs (1:1 Coaching).

Click here to learn more about the Emunctory Ebook

Click here to learn more about our Stress Awareness Workshop

Click here to learn more about ReThink Wellness Academy

Click here to learn more about Restoring Balance

Click here to learn more about our Inner Circle

Click here to learn more about 1:1 Coaching