GOOD WOMAN: Submit Your Application

GOOD WOMAN: Long-Term Coaching Application

Welcome! I'm so glad you're here. GOOD WOMAN is for women navigating the depths of heartbreak, ready to process their loss, receive customized flower essence support, and return to themselves with clarity and emotional steadiness.

This application helps me understand where you are in your journey and how I can best support you in this season of your life. There is no right or wrong way to answer—simply share from the heart.

Once submitted, I’ll review your application and reach out with next steps.

Personal Information

First name

Last name

Email

Phone (for scheduling a follow-up)

Timezone

Birthday

Month

Day

Year

Your Story & Where You Are Now

Briefly describe yourself and your current situation. What would you like me to know?

In your own words, what draws you to GOOD WOMAN?

What are your top three struggles right now as they relate to your breakup, emotions, or sense of self?

How has this breakup affected your daily life, emotions, and relationships?

Patterns & Challenges

Check all that apply to your experience

Feeling emotionally destabilized—like you lost a part of yourself.

Waking up in panic, anxiety sitting on your chest.

Fixated on the past—replaying conversations, searching for meaning, unable to let go.

Experiencing waves of deep grief that come out of nowhere.

Having recurring dreams about your ex that won’t stop.

Feeling a primal fear of being alone, even if you logically know you’ll be okay.

Struggling with self-recrimination—asking yourself, "What did I do wrong? How could I have prevented this?"

Noticing physical symptoms—tightness in the chest, body aches, shortness of breath, fatigue.

Losing interest in daily life, feeling numb, disconnected, or unable to focus.

Turning to distractions—immersing yourself in TV, social media, food, work, or dating apps to numb the pain rather than face it.

All of the above.

Which of these areas do you most want support with?

Your Healing Journey & Readiness for Integration Coaching

How long have you been processing this breakup? Have you tried anything to support yourself through it?

One year from today, how do you want to feel in your heart, body, and mind?

What do you believe is keeping you stuck in the pain of this breakup?

Why do you think coaching with me specifically could help you?

Have you worked with energetic or plant-based healing modalities before (e.g., flower essences, homeopathy, herbalism, energy healing)? If so, what was your experience? If not, are you open to exploring subtle yet profound forms of emotional support?

Commitment & Investment

GOOD WOMAN is an emotional and financial investment in yourself. Are you prepared to invest financially in your coaching journey?

YES - $500 - $1K per month

YES - $1K - $1.5K per month

YES - $1.5K or higher per month

NO - I am not able to invest these amounts.

If YES, how much per month are you able to invest in yourself?

If NO, please share any thoughts on your financial situation and what feels feasible for you at this time?

Is there anything else you’d like me to know?