Joy Jumpstart Session Application
Hello and thank you for applying for your Joy Jumpstart session with me!
I am truly looking forward to meeting you and learning how I might be able to support you on your personal journey.
To make the most out of time together, please complete the confidential questionnaire below. It will only take a few quick minutes!
Thanks! I look forward to meeting with you!
Dana Zarcone
Founder, Source Your Joy
Helping you Dance with Life Again!
P.S. Oh yeah ... there's only one caveat! Since I"m a Counselor, you have to be 18 or over.
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Please provide your first and last name
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What is your email address?
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Please provide your phone number
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What are the biggest challenges you're facing right now?
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Approximately how long have you been faced with these challenges?
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On a scale of 1 -10 (10 being the highest) how important is it to get these challenges solved, and why?
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What strategies have you used to overcome these challenges up to point (ie. group support program, therapy, medication, self-help books, energy work, yoga, meditation, coaching, etc.)
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How committed are you to overcoming these challenges?
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Are you currently working with a counselor, coach or therapist?
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Have you worked with a counselor, coach or therapist in the past?
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If you are currently working with one, or have in the past, how long have you worked with him or her? (Note: does not need to be consecutive)
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What intrigues you about potentially working with me?
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How did you find out about the opportunity to meet with me?
