Breakthrough Session Application Name * First Name Last Name Email * Phone * (###) ### #### Please share your primary health concerns that you seek support. * Do you have a spiritual practice? (i.e. yoga, qi gong, etc.) * What type of personal development work have you done? * What is your vision for yourself? (in health, relationship, career or other important areas you're interested in focusing on) * How deep is your level of commitment toward addressing this vision in the next year? Please provide a number between 0-10 (0: non-existent, 10: fully committed). * What will be the cost if you don't create this vision for yourself? * Who would be paying for your services? Self Spouse Self and Spouse Parents Extended family members Other How willing are you to commit emotionally, financially, and mentally to overcome these challenges? * No resources available right now Hesitant to commit Preparing some resources Resourced and ready Whatever it takes... let's go! How did you hear about Whitney? * Please share anything further you feel is important for me to know about you. * Thank you! Your application has been successfully submitted. Whitney will reach out to you directly with a private message after reviewing your application with more details on your next steps. You're welcome to go ahead and book your Breakthrough Session time now on her online calendar link HERE.
