Menopause Mentoring... Application Form

A Few Simple Steps…

Please Submit Completed Menopause Mentoring Form
You will receive an email or call from the Concierge to arrange a convenient time for a virtual Clarity Call.
Clarity Call with Beth is an opportunity to learn more about each other and expectations.
Typically a 30-minute discussion to better understand your needs.

Look Forward to Supporting You! Bethx

Please Complete & Submit, Thank You

First name*

Last name*

Email*

Country*

Mobile number*

How do you spend your time?:*
Full-time employmentEntrepreneur or Start up OwnerPart-Time EmploymentContractorManaging Household and FamilySole Business OwnerTurning Hobby or Dream into BusinessOther (please fill-in)

Other expertise*

Describe your current marital status and contentment factor -- divorced, new partner, single, long-term partnership?:*

Describe what keeps you busy during the day?:*

How do you sleep on most nights?:*

How often of you exercise or move your body?:*

Business name*

Business website*

What does your existing business or new one offer?:*

Describe your stage of menopause such as pre, post, in the throws of it.:*

Describe how you feel about yourself on most days?*

Describe your energy level on most days?*

Describe your hobbies and interests?*

What are the top 3 issues you would like to be mentored on related to your menopause journey?:*

Why are these 3 issues important to you now?:*

What do you expect from working with Beth?*

Please list your Instagram, Social Media and LinkedIn details:*

Regardless of whether you desire coaching and mentoring for menopause, your business or life, please share why you are contacting Beth today?:*

What would you like your life to look like in 3 months?:*

What are the 3 things that you would like to feel better about, achieve, receive, or accomplish in 12 months?:*

Do you have the finances to start your mentoring journey this month?*

Do you believe in complementary and holistic wellbeing practices such as meditation, Yoga Nidra, Theta Healing, Reiki and more?*

What would Beth not know to ask you that is of importance to you?:*

Have you or are you currently being treated for depression or anxiety by a health professional?:*

Do you have any health or medical conditions that are being treated by a health professional?:*

Do you have an established relationship with a menopause specialist or GP to provide medical advise?:*

Your message*

I have read and accept the Privacy Policy.

Menopause Mentoring... Application Form

A Few Simple Steps…

Look Forward to Supporting You! Bethx

Please Complete & Submit, Thank You

Thank You For Your Interest…You’ll receive an email shortly.

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