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What would you like to see created?

I want to hear from YOU, because no one knows what you need better than you.

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Question 1 of 9

Hello sweet soul, thank you for being here. Tell me a little about you & what resonated to be here today filling out this form?

Question 2 of 9

What does Recovering & healing after Pregnancy Loss mean to you? How do you want to feel? How do you want to see your life? 

Question 3 of 9

What are you struggling with? 

(Select all that apply)
A

Fear / Anxiety

B

Finding it difficult to make life decisions

C

Intense & Overwhelming Grief / emotions

D

Self Sabotage & Blocks stopping you from experiencing anything good in your life?

E

Reacting that isn't proportionate to the situation

F

Anger & Pushing people away

G

People pleasing

H

OTHER (space in next question to elaborate)

Question 4 of 9

OTHER - What is it you are struggling with the most right now?

Question 5 of 9

What would you like to see created for you to help you navigate your days with more ease, more confidence & more flow? 

Question 6 of 9

How do you learn best?

(Select all that apply)
A

Hands on?

B

Self-paced?

C

Need accountability?

D

1:1 Programs

E

Group programs?

F

Other

Question 7 of 9

OTHER - feel free to elaborate on previous question

Question 8 of 9

I have free resources on my website, have you had a chance to view them yet?

A

Yes

B

No

Question 9 of 9

THANK YOU!
I have been in your shoes, I know the depths of despair & I know all to well the feelings of guilt, anxiety, shame, fear, blame & shame. I am here for you no matter what. I invite you to allow me to support you. 

You can book a time to discuss programs through the Contact Me portion of the Website: www.sharnasouthan.com

 

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