Please Read Before Completing

My mentorship is for women who are serious about building a profitable health practice that supports their faith, health, family, and community.

I value your time and resources, as I do my own — so by completing this form, you are acknowledging this as your first step toward investing in your God-given calling.

If you’re ready to honor God in your home, health, finances and business, and to be equipped with the strategy to grow a sustainable practice, then my mentorship is for you.

First Name *

Last Name *

Date of birth

Email *

Phone *

Business Name *

Website URL

Instagram handle (list Tiktok if you have one)

List any undergrad or advanced college degrees you have or are working towards. Do you have any licensure or certifications related to your business pursuits?

How long have you been in business?

Haven't started

Started but don't have clarity or goal income

Have had my business, earning consistent $2k-3k months and I ready to grow my income and impact

Where are you at in your business journey?

Ex; Haven't started, have an LLC but not sure how to market, have an IG but no clients or clarity on how to create content, have a full time job and haven't started, am a student but am 100% ready to get started NOW

What is your average monthly income from the last 6 months in your health business?

0-$500

$500-$2,000

$5,000-$15,000

What are your top 2 business goals right now?

Why are your goals important? What is motivating you to make it happen NOW?

What do you feel like you need from a coach/program to achieve these goals?

Who is your dream client?

What are your 3 biggest struggles/challenegs with your online business?

Are you in a place to invest your time and finances to reach your goals?

Yes, I'm in!

Not right now

On a scale of 1-10, how ready are you to make a premium investment in yourself and your business?

To help make the program accessible to multiple budgets, we do have payment plans to help spread the investment over several months.

Are you current or past Wise Woman Student?

Yes

Check yes if you have purchased the Wise Woman Practitioner self-paced course

What are you most interested right now?

Group Mentorship

Private Mentorship

In person mentorship including personal branding shoot (location: Rochester, NY)

Did someone refer you to my programs or the Wise Woman Practitioner Group?

Yes

If referred please place name below:

Do you currently have any health concerns I should be aware of?

I consent to receive communications and understand I can opt-out at anytime.