Private Coaching Application

Section 01 of 08

Basic Information

Full Name Please enter your full name.

Email Address Please enter a valid email address.

Phone Number Please enter your phone number.

Current Location Please enter your location.

Current Role / Profession Please enter your current role.

Website or Social Media Link Optional

Section 02 of 08

Current Situation

Choose the option that most accurately reflects where you are right now.

Which best describes your current situation?

I know what I want, but I keep stopping myself from taking the actions required

I am already performing at a high level, but I feel I've hit an internal ceiling

I'm not fully sure, but I know something deeper needs to change

Please select an option.

Section 03 of 08

The Problem

Be as specific and honest as you can. The more clearly you can articulate the pattern, the better I can assess whether there is a fit.

What is the main pattern, challenge, or internal struggle you want to change right now? Please answer this question.

Where is this affecting you most right now?

Select all that apply.

Business or career

Leadership or performance

Confidence or visibility

Health or habits

Relationships

Emotional wellbeing

Decision-making

Other

Please select at least one area.

What has this been costing you? Please answer this question.

What have you already tried to change this? Please answer this question.

Why does this matter now? Please answer this question.

Section 04 of 08

Desired Outcome

Describe what you are actually moving toward, not just what you want to stop.

What outcome are you seeking through this work? Please answer this question.

If this work were successful, what would be different in how you think, act, lead, or perform over the next 6 to 12 months? Please answer this question.

Section 05 of 08

Readiness and Fit

Answer honestly. There are no right answers here. Only accurate ones.

Are you looking for deep transformational work, or more general support and accountability?

Deep transformational work

A mix of both

Mostly support and accountability

Please select an option.

Are you willing to be challenged directly in service of change?

Yes

Somewhat

No

Please select an option.

Are you prepared to prioritize this work over the next three months?

Yes

Possibly

No

Please select an option.

How ready are you to begin if accepted?

Immediately

Within 30 days

Within 60 days

Just exploring

Please select an option.

Section 06 of 08

Financial Qualification

Private coaching requires a meaningful financial investment. These questions are not designed to disqualify. They are designed to ensure that any commitment made is one you can fully step into.

Private coaching requires a meaningful financial investment. Are you prepared for that level of commitment if we determine there is a fit?

Yes

Possibly

No

Please select an option.

My elite immersive work involves a significantly higher level of investment and includes private in-person travel-based work. Would you be open to discussing that level of commitment if it appears to be the best fit?

Yes

Possibly

No

Please select an option.

Section 07 of 08

Path of Interest

If you are unsure, select the third option. This will be part of the consultation conversation.

Which path are you most interested in?

12-week private coaching

Elite immersive work

I'd like guidance on the best fit

Please select an option.

Section 08 of 08

Final Question

This is your opportunity to share anything that did not fit elsewhere: context, nuance, or anything you want me to know before I review your application.

Is there anything else I should know in considering your application? Optional

Application received.

Thank you for completing this thoughtfully. I review each application personally. If there is alignment, you will hear from me directly with an invitation to a private consultation.

Please allow up to 24-48 hours for a response. Check your inbox, including your spam folder, for a message from Erin Birch.