WAITLIST APPLICATION — SEVEN SENSES

Please complete the form below to be placed on the waitlist for Erica’s private practice. We will be in touch shortly.

Name

First Name

Last Name

Where are you located?

Age

Profession

How did you hear about Erica's work?

What’s your biggest challenge these days?

How is it affecting the rest of your life (relationships, health, work, etc)

Where do you get the most stuck trying to solve this?

What would your life be like if that challenge was gone? What would you be able to do/be?

What are the top 3 things you would like to accomplish with this work?

What types of work have you tried in the past?

What do you love most about yourself?

Erica works with people in a minimum of 3 month containers and sees clients 2x/month. How long are you prepared to commit to your transformational process?

3 months

6 months

12 months

What outcome would you want from working with Erica?

How much are you willing to invest to get the outcome you want?

$1000-$1499 per month

$1500-$1999 per month

Over $2000 per month