Breathe & Bloom Boldly

Application: 

Stepping into Calm Clarity


Hello! It takes beautiful wisdom and courage to begin this journey. This first step is already moving you toward more clarity and peace.

This form is designed to help me understand where you are right now and ensure that my approach is the perfect fit for your journey to authentic self-alignment.

Please answer honestly. What you share here is seen only by me, and everything remains private

Click 'Submit' to book your complimentary Somatic Discovery Call. This is the final step for us to determine if we are beautifully aligned to begin your journey to authentic self-alignment.


If you could uncover one piece of core truth about yourself in the next three sessions, what would it be?*
When you think about feeling fully aligned, what feeling or state of being are you most longing for?*
In simple terms, what is the biggest thing that is holding you back right now?*
To ensure I meet you where you are, which statement best describes your readiness for this process? (Please select one.)*
Could you please briefly share what you know about breathwork or somatic coaching, or if you've previously engaged in any body-based healing work?*
Do you have a history of or are you currently experiencing any of the following serious conditions? (Cardiovascular disease, detached retina, glaucoma, aneurysm, severe asthma, epilepsy, kidney disease, severe psychiatric condition like Bipolar/Schizophrenia, active recreational drug use, or recent major surgery/injury.)*
Regardless of your answer above, please list any relevant conditions you have experienced (including high blood pressure, mild asthma, PTSD, pregnancy, or use of any psychiatric medication). (Please use the list below for reference—everything you share is held in strict confidence.)*
What is the best email and phone number for me to contact you if we need to reschedule our connection time?*