Full Name
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First and Last
First Name
Last Name
Email
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Phone Number
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How did you hear about this group?
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Do you manage a team? If yes, how many people do you oversee?
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What aspect of your leadership role causes you the most stress or anxiety?
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How frequently do you feel overwhelmed by your responsibilities at work?
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Not at all
Several days
More than half the days
Nearly every day
How often do you feel emotionally drained after a workday?
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Not at all
Several days
More than half the days
Nearly every day
Do you experience physical symptoms of stress (e.g., headaches, fatigue, tension)?
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Yes
No
How comfortable do you feel discussing work-related stress with peers or supervisors?
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Very comfortable
Somewhat comfortable
Not comfortable
Why are you interested in joining this group? What do you hope to gain from the experience?
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Are you willing to actively participate in weekly sessions, complete pre-work, and engage in the community?
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Yes
No
The group cost is $888, with payment plans available. Are you prepared to make this financial investment in yourself?
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Yes
No
Are you the primary financial decision-maker in your household? If not, do you need support in communicating the importance of this investment to your partner or spouse?
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Yes
No
Would you consider requesting funding from your employer to support your participation? If so, what information would you need from us?
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What motivates you to take this step now, at this point in your leadership journey?
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Is there anything else you would like us to know as we review your application?
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Your journey toward stress relief and resilience starts here. Once you’ve submitted your application, you’ll be directed to book your consultation.
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I acknowledge
