Yes, I'd like to apply for a Discover Your Genuine Self Session...

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Thank you for your interest in my Discover Your Genuine Self Breakthrough Session.  

Your next step is to complete this brief application to determine if you qualify for this complimentary session.

I know what a vulnerable step it is to even reach out and to share a bit about yourself and where you're at in your healing journey. Since I've been doing this for a long time, I know that I'll be able to determine how I can be of best service to you and what our best path forward can be based on your answers to this application. So I want to thank you in advance for taking the time to complete this application.

If you have any questions or concerns, please feel free to email me at
It's completely unimportant.
It's the most important thing to me right now.
I don't have the resources (time, energy, money) right now.
I am ready to invest time, energy, and money towards my healing journey.
7. What type(s) of abuse did you experience? (OPTIONAL)
8. What age(s) did you experience abuse? (OPTIONAL)