StressBeGone Sign-Up

Complete the form below to book your 25-minute consult ($35) and take back your calm.

Consult available in my Lloydminster office, live online, or by telephone. Everything you share stays in your confidential client file.

Your information

First name

Last name

Mobile phone

Age

City / Province

How did you hear about us?

Preferred format

Your stress profile

Where is most of your stress coming from? (check all that apply)

Work / CareerFinancesFamily / RelationshipsHealth / IllnessCaregivingOverwhelm / Time pressure

Anything else? (optional)

How long has your stress been at this level?

Your body & sleep

Which of these do you notice? (check all that apply)

Muscle tension / jaw clenching / tight shouldersRacing mind / trouble shutting off at nightShallow breathing / chest tightnessIrritability or short temperDigestive upset / nervous stomachChronic fatigue despite sleepingHeadachesTrouble concentrating

Average hours of sleep a night

Impact & motivation

On a scale of 1 to 10, how stressed do you feel most days?

On a scale of 1 to 10, how badly do you want to reclaim your calm and control?

In a few words, what is stress costing you right now?

How do you cope with stress now?

Picture yourself calm and in control — what does that look like?

I have read and agree to the client consent form.