Coaching Request Form Tell us what feels stuck, what you want to change, or what you’re ready to build next. Share as much or as little as feels useful. Name(Required) First Last Email(Required) PhoneWhat brings you here?(Required) I’m feeling stuck or overwhelmed I want more clarity on what I actually want I need help making a real change I want better habits or structure in my life I’m ready to redesign a major part of my life I’m interested in private 1:1 coaching I’m not sure yet — just exploring What would you like to share?(Required) What’s feeling heavy or wrong (pain points) What I’m hoping to move toward (goals) Select one or both — this shapes how we read your response.What are the main pain points you’re experiencing?What goals or outcomes are you hoping for?Which area of life feels most relevant right now? Career or business Time and calendar Relationships Health and energy Joy, fun, and adventure Confidence or identity Boundaries A major life transition Something else Check all that apply.What kind of support sounds closest to what you need? A single deep-dive session to get clarity fast A 90-day structured plan with regular check-ins High-touch private support with real-time access A full life redesign from the ground up I honestly have no idea yet Don’t overthink this — we’ll find the right fit together.How ready are you to make a change?(Required) Still exploring — no pressure I know something needs to change I’m ready in the next month or so I’m ready now Anything else Leah should know before you connect?Consent(Required) I agree to be contacted about coaching, events, or related Living La Vita Ladies offerings.
