Application | ThriveWell

Curious about working together?

This application and complimentary 30-minute discovery call is an opportunity for us to connect, learn more about your journey, and explore what’s possible for your health and healing beyond cancer or beyond your diagnosis. You’ll have space to ask questions, hear more about my approach to lifestyle medicine and coaching, and see if this is the right fit for you.

This is designed for women who are ready to move beyond simply surviving and are seeking guidance, support, and a personalized path forward.

Name

Phone Number

Age

Referred by/How did you hear about me?

What brings you to this call? This call is a chance for us to learn more about you and your goals, and to ensure we’re the right fit for your care. Please briefly share what you’d like to support with - like help with symptoms post cancer treatment, to feel better, have more energy?

Have you worked with a health coach before?

Yes

What is the main area of your health that you’re hoping to improve or get support with?

What has been the biggest obstacle in hitting your health goals and feeling your best?

So far in your journey, what have you tried to fix these symptoms/complications?

If we could wave a magic wand and help you feel your absolute best this year-physically, mentally, and emotionally- what would that look like for you?

Do you know we operate as a concierge practice (no insurance billing, high-touch care that is personalized to your needs)?

Yes

No, I’d like to learn more

What is the primary reason you are seeking concierge care over traditional care?

More personalized attention

Access to longer appointments

Holistic care and support

Convenience and flexibility

How do you prefer to be supported in your care?

When it comes to making this health transformation a priority, what level of investment feels aligned for you?

Is there anyone else (spouse, partner, or parent) involved in your decision-making process? If so, will they be attending the call?

Yes, and they will be on the call

Yes, but they will not be on the call

No, nobody else is involved in the decision

How soon are you looking to start working on this so you can feel your best?

Immediately

Within the next month

Within the next three months

I’m just exploring options for now

Why is it important that you solve these health challenges right now VS. a year from now?

How committed are you to making lifestyle changes to reach your health goals?

Fully committed, willing to do whatever it takes

Somewhat committed, but need support

Looking for guidance, but not sure if I can fully commit yet.

You’re here for a reason.

A part of you is ready for something more—and this is where your next chapter begins.

Once you submit your application, you’ll gain access to schedule a complimentary private 30-minute 1:1 clarity call. This is a space for us to connect, explore your goals, and gently uncover what may be standing between you and the life you’re meant to live.

Together, we’ll bring clarity to your next steps and determine if this journey is the right fit for you

Please note: This is not a medical consultation, and no personalized medical advice, diagnoses, or lab reviews will be provided during this call.

This Is Where You Stop Surviving… and Start Thriving!

Let’s Work Together!

Curious about working together?

You’re here for a reason.

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