TO GET THROUGH THE DAY?
JS Coaching Application Form
Choose which best describes your situaion:
Are you currently in crisis, in need of immedate support?
Yes, but it is under control
Have you been to therapy before?
Yes, for many years
Yes, but only for a few sessions
No, I am just starting out
No, I have been afraid of therapy
Yes, but have not made progress
Yes, but I am ready for next level
When I feel too much I ...
I want to run away and hide
I want to shout and yell
I have a panic attack
I want to harm myself or others
I freeze and shut down
I do not know how to feel
On a scale of 1 - 10 (10 being on fire and ready and 0 being flat and unsure) how ready are you to invest in your healing?
Thanks for submitting! I will be in touch within 24 hours.