Please take a few minutes to complete this form.

Click the button below to start.


Question 1 of 7

Where are you located (please include city & country)?

Question 2 of 7

If there were no obstacles in your way, what would you LOVE to create in your business?

Question 3 of 7

What have you already tried to help you get closer to your dream vision?

Question 4 of 7

What obstacle(s) or challenge(s) are holding you back?

Question 5 of 7

Which programme are you MOST interested in applying for now?


Startup Therapy: The Catalyst (1-hour, 1:1 session)


Startup Therapy: The Retreat (2-day 1:1 retreat)

Question 6 of 7

We understand that everyone's financial situation is different, so we would like to ask you: Considering the value and potential impact of your preferred programme, what amount would you feel comfortable investing to secure your participation (in British Pounds, GBP)?

Question 7 of 7

Why would you be a good fit for the Startup Therapy coaching & training programmes?

Confirm and Submit