Application HypnoCoaching - Dominique LaCroix

Application for HypnoCoaching®

This is the first step of the process towards a "New and Improved" version of yourself!! It's totally risk free, so make the leap, fill in the application, and I'll be in touch to guide you with integrity and honesty in making the best decision for YOU. Be assured I will not misguide you. I have your best interests and well-being at heart. If I don't believe I am the best person to serve your needs, I will be very honest about it. What I mostly care about is how WE can get you to be WHO you want to be, and get you to where YOU want to go in your personal life, and professional life if so is the case.

Please Note: This application has 2 stages:

Completion and submission of the application form.

After I review your application and determine I can help you reach your desired outcome, I will invite you to a FREE 30 minutes consultation to discuss your growth objectives in more detail. At the end of this consultation, both parties can make informed decisions as to whether to engage or not, discuss terms, availability and start dates.

Once you have submitted your application, please allow 2 working days before getting a response. Please ensure to add my email address dominique@empowered2live.com to your address book, in order to prevent messages from Empowered2Live Consulting & Coaching to be recognized as spam.

First Name

Last Name

Mailing Address

Zip/Postal Code

Email Address

Have you ever been hypnotized before?

Yes

If yes, where?

When?

Reason?

What was the outcome?

Qualification Questions:

1. What brings you to want a coach now?

2. What are the 3-5 main objectives you want to accomplish from the coaching relationship?

3. Describe the kind of engagement you think you need (i.e. what are you looking for from the expertise you want to hire?)

4. What brings you to apply to HypnoCoaching, as opposed to coaching alone? Have you experienced HypnoCoaching in the past? Please describe in a few words.

Please tick your preferred option:

3 months

6 months

12 months

Please Note: If your application is successful, all fees are payable in full 10 days in advance of commencement of the program. Should you decide to stop following the program before the end, you will be charged the rate of individual sessions for the number of sessions that you benefited from, plus an additional $87.00 of administrative fees. You will be reimbursed the balance of all other fees.

**By submitting this application, I acknowledge that I have read, understood, and accepted the cancellation policy stated above.

Application for HypnoCoaching®

Please Note: This application has 2 stages:

Contact

Services

Navigation