Form

Discovery Call

Mindset Coaching Application Form

I cannot wait to connect with you! Before we meet, I would love to know more about you.

The complimentary discovery call is designed to help you identify how Mindset coaching can help you reach your potential and live a life more in line with your values.

First Name*

Last Name*

Email*

Phone Number*

Postal address*

Date of Birth*

Day-Month-Year

How do you think coaching with Cosi would help you?

What are you passionate about? What things light you up? *

Any values, hobbies, interests, personal philosophies etc.

What’s the main reason you‘re looking for coaching?*

Tell me about the outcome you'd like to achieve or the problem you'd like to solve by working together

What area of your life are you wanting to manifest changes in most right now? Select all that apply.*

If you had a magic wand that could make your biggest wish come true, what would you wish for right now?*

Which of the following do you feel would help you most right now? Select all that apply.*

I want to let go of my limiting beliefs and build more trust in my ability to live in line with my values

I want to feel more confident within myself

I want to improve my relationship with my body, food and nutrition

I want to quit my job and/or start a new business

I want to feel happier and more positive

I want to do some soul-searching and find my inner purpose

I want to establish healthier routines and habits

I want to learn how to navigate the lows in my life and feel better able to manage my emotions

I want to heal my childhood trauma and let go of the past

What solutions have you already implemented to try and improve your situation?*

What do you think is still blocking you?*

What would your ideal week look like?*

What things are getting in the way of you living your ideal week?*

These could be practical or mindset related barriers.

What do you do for self-care?*

Please feel assured that all of your answers and comments are secure and confidential and will never be shared to any external persons.

Once you click the submit button below, I will receive your responses and contact you to book in your complimentary Discovery Call.

I am looking forward to connecting with you soon!