Address Line 2
State / Province / Region
ZIP / Postal Code
Antigua and Barbuda
Bosnia and Herzegovina
Central African Republic
Congo, Democratic Republic of the
Congo, Republic of the
Northern Mariana Islands
Palestine, State of
Papua New Guinea
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
United Arab Emirates
Virgin Islands, British
Virgin Islands, U.S.
Describe what your current life stressor’s are
Describe what is in place to help you cope with your current life stressor’s
What do you hope to gain from this process?
Examples: - Claiming my worth - Finding my courage - Changing my negative thought patterns - Managing daily ups and downs -Creating more meaning and purpose in my life -Staying in consistent action with my recovery -Productivity and time management -Increasing my energy -Clarity on my goals and life direction -Resetting my ability to co-create -Increased awareness on the power of intention -Learning how to set boundaries with others -Learning how to set boundaries with self -Connecting to my needs and wants -Finding joy in a lifestyle of moderation -Managing my reaction -Staying out of judgment -Utilizing positive affirmations -Overcoming fear and limiting beliefs
Have you ever worked with a life coach before?
High Vibe Soul, LLC Have you been in therapy before? How old were you? What was your experience?
Have you received treatment in an inpatient facility before? If so, when and for how long were you there?
What would you MOST want to work on together?
And if we were to work on that, what would be your ideal outcome. The outcome that would make you realize that you had succeeded?
If we achieved this together, what would that outcome do for you? How would it make you feel?
I have filled out the High Vibe application to be considered for a spot in High Vibe Soul Society. At this point in time, I understand I am showing interest only in the program and am under no obligation to join or make a payment. I understand that if I am accepted into the program, after reviewing and submitting my payment contract (supplied after this document is received and approved), I am committed to the program for its duration. I understand my role and the role of my consultant in this program. I will ask questions and clarify anything I don’t understand. I am committed to doing everything I need to do to get 100% from the program. I understand this program is in high-demand and I may not be part of this program this round. If that’s the case, I am always welcome to re-apply if it opens again in the future, or choose another program that’s a better fit at this time. I understand that a separate payment contract will be submitted to me for my review after this application is accepted. By entering my name and today's date below I indicate my agreement to these terms.
Please note that our service is compliant with HIPPA and every opportunity is made to keep your information secure. Once your application is received, one of our team members will reach out to you to set-up a time to have a clarity call. By sending your application you are agreeing that High Vibe Soul, LLC or any of the persons affiliated with High Vibe Soul, LLC will not be held liable for any damages of any kind resulting or arising from including but not limited to: direct, indirect, incidental, special, negligent, consequential, or exemplary damages happening from the use or misuse of this service. Client (“applicant”) agrees that use of this service is at user’s own risk
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