1:1 Coaching Form

Hi, my name is Shana! I'm so glad you're here. Grab a cup of coffee, and pull up a seat. Let's talk about some of your goals!

Personal Information

Where You Are Now & Where You Want To Be

What are you struggling with the MOST right now in your life? (how are you feeling, what are you going through, where are you stuck, etc. *

What do you want MOST in your life right now? (Ex. self-acceptance, deeper relationships, a new career, to build a personal brand, etc.) *

What are some of the biggest obstacles, fears, & insecurities standing in the way of having what you want? *

What will you have you say that our coaching sessions were valuable? In other words, what is the desired outcome, result, and/or feeling you want to have after working with me? *

Briefly describe your experiences (if any) in the realm of therapy, coaching, self-help workshops, retreats, plant medicine, etc.

Please note: My coaching is designed to provide support, guidance, and encouragement, but it’s not a substitute for professional mental health care. If you are experiencing a crisis, please contact a licensed mental health professional.

Upon submission of this form, you'll be directed to book a call with me so we can further discuss your inquiry for 1:1 coaching.