1:1 Cycle Coaching

Application Form

Full Name

How connected do you feel to your menstrual cycle right now? Do you track it? Do you notice patterns in your mood, energy, or body throughout the month?

What has been your experience with your cycle so far? Are you experiencing any pain, problems or conditions? Please list anything you are experiencing with your period. (e.g., PCOS, Endometriosis, PMS, irregular cycles, or other symptoms)?

What is your relationship with your period like? Is it positive and hopeful, or negative and disheartened? There is no wrong or right answer. Just your truth in this moment.

Are you willing to devote your time and presence to healing your cycle over the 12 weeks? You will be supported along the entire journey.

What do you hope to gain from this program? What specific outcomes or changes are you hoping to achieve?

Did someone refer you to the program? What is their full name?

Would you like to pay in full or have a payment plan?

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1:1 Cycle Coaching

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