16 week intensive application

Preferred Method of Contact *

Please confirm your understanding of the program requirements(by checking each of the following, you are agreeing to each statement):*

I understand this is a 16-week private coaching intensive with weekly 1:1 sessions.

I am able to consistently attend scheduled sessions over the full 16 weeks.

I understand this program includes structured exercises, journaling, and daily practices outside of sessions.

I am willing to actively participate and take responsibility for my transformation.

I understand this is an immersive identity recalibration process, not passive coaching.

Are you able to commit to weekly sessions for the full 16 weeks?*

Yes

Which best describes your general availability?*

Weekday mornings

Weekday afternoons

Weekday evenings

Flexible

Are you prepared to prioritize this work alongside your current responsibilities?*

Yes

Unsure

What is your primary reason for applying to the 16-Week Intensive at this point in your life?*

If this experience were successful for you, what would be different about your life at the end of 16 weeks?*

Which areas currently feel most out of alignment for you?*

Identity / sense of self

Emotional patterns

Relationships

Career or purpose

Confidence or clarity

Life transition (divorce, loss, burnout, recovery, etc.)

Other

What patterns do you feel you keep repeating, even though you’re aware of them?*

How do stress or emotional challenges typically show up for you?*

Overthinking

Emotional shutdown

Reactivity or anger

Anxiety or fear

Avoidance or procrastination

Physical symptoms (fatigue, tension, etc.)

Have you previously worked with a coach, therapist, or guide? If yes, briefly share what worked and what didn’t.*

On a scale of 1–10, how ready are you to release outdated identity patterns and step into a new way of being?*

What do you believe has held you back from fully stepping into the version of yourself you know is possible?*

The investment for the 16-Week Quantum Identity Alignment™ Intensive is $6,000.Please indicate your preferred payment option:*

I am prepared to pay the investment in full

I am interested in exploring available payment plan options

Is there anything else you feel is important for me to understand about where you are in your journey right now?*