Application (Step 1/3)

Apply to join the program in just three easy steps:

Step 1/3: Complete this form

Your email?

Your name?

Your surname?

Your phone number?

Age

What is your job?

What are the main challenges you face with your sleep?

Check all that apply

Trouble falling asleep
Waking up during the night
Waking up too early
Feeling tired even after sleeping
Nightmares or anxiety
Other. Cliсk to write your answer

How long have you been struggling with these issues?

Have you tried any sleep strategies or treatments in the past?

What worked? What didn’t?

List all medical conditions you currently have (if any).

Are you currently taking any medications or supplements? If yes, please list them.

10. Are you currently working with any other therapists, coaches, or programs related to sleep or mental health?

What specific goal(s) are you trying to achieve from this programme?

When are you ready to start?

What would success look like for you by the end of our work together?

What do you think might get in your way during the programme (e.g., time, mindset, habits, life stress, etc.)?

How much time per week are you realistically willing to commit to this programme?

Why is now the right time for you to work on your sleep?

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Based on your responses, we will assess whether we can meet your expectations. The more detailed your answers, the better the chances of a smooth and rewarding collaboration.

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