What's your name?

What is your email? 

Where are you based? (City/time zone)

What's bringing you to Unleashed: Guided right now? What's going on in your life that made you fill this out today? 

Haev you done any of Melissa's work before (the self-paced Unleashed, the free content, the books, the community)? What's your history with it? 

What would be different for you by the end of 90 days? Paint the picture

This is a 90-day commitment with a daily practice and a group you show up for. Realistically, do you have the space in your life right now to be in it?

Are you currently working with a therapist, counselor, or other mental health support? (Not a yes/no gate. It just helps to understand how to support you best, and whether a group container is the right fit for now.)

Is there anything going on for you right now, emotionally, mentally, or health-wise, that you'd want Melissa to know so she can support you well, or so she can be honest with you about whether this is the right time?

Unleashed: Guided is $ 2,800 when paid in full or in 3 payments of $1,000. Are you clear on the investment and ready to move forward if you are accepted? 

Anything else you want Melissa to know?