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Living in Luteal  Private Client Application

Thank you for your interest in the Living in Luteal Private Program. This application is designed to assess where you are on your healing journey and ensure we are the right fit to guide you toward the transformation you desire. Please take a few moments to answer the following questions honestly and thoughtfully.

Click the button below to start.

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Question 1 of 10

 

1. How are your severe PMS or PMDD symptoms impacting your life?

(Select all that apply)
A

My relationships (with partner, family, or friends)

B

My career and productivity

C

My mental health (e.g., depression, anxiety, rage)

D

My physical health (e.g., fatigue, body pain)

E

My self-worth and identity

F

Other

Question 2 of 10

2. If you chose “other” in the previous question, please specify how severe PMS or PMDD symptoms are impacting your life.  If you did not choose “other”, please type ‘n/a’ below.

Question 3 of 10

3. How committed are you to your healing journey?  

 

(1 = Not ready, 5 = Fully committed)

A

1

B

2

C

3

D

4

E

5

Question 4 of 10

4. What are the top 3 changes you want to experience through this program?

Question 5 of 10

5. What have you already tried to manage your PMDD symptoms?

(Select all that apply)
A

Medication (SSRIs, birth control, etc.)

B

Therapy or counseling

C

Supplements or diet changes

D

RTT (Rapid Transformational Therapy)

E

Other

Question 6 of 10

6. If you chose “other” in the previous question, please specify how you’ve already tried to manage your symptoms.

If you did not choose “other”, please type ‘n/a’ below.

Question 7 of 10

7. Why do you feel this is the right time to work together?

Question 8 of 10

8. Are you ready to invest in your healing journey?

 

The total investment for the Living in Luteal PMDD private program is $8,888. Choose the payment plan option below for more information. Some insurance providers cover hypnotherapy, and an invoice will be provided for you to submit for reimbursement.

A

Yes, I’m ready and prepared to invest.

B

I am committed to finding a way to make this investment.

C

I would like more information on payment plan options.

D

I need to explore financial options.

Question 9 of 10

9. What would a fully transformed life free from PMDD look like for you?

Question 10 of 10

10. Is there anything else you’d like us to know before we begin this journey together?

Confirm and Submit