1:1 Coaching Application

9 week program

My 1:1 coaching focuses on deeply transformational work that many have called “life-altering” and a “mental sharpening”. If you’re open to the coaching and ready to be honest with yourself, I can guide you to getting aligned with the best version of your future self.

Filling out this application will put you into a waitlist to work 1:1 with me as my client roster is currently full.

**If you are approved, when a slot opens up you’ll receive an email confirmation and a link to schedule an interview Zoom call with me to dive deeper.** At that time, you will have the chance to express your unique circumstances and learn how AK can help you find clarity, move through feelings of being stuck in a loop and back into a direction focused on personal growth and excellence.

*Disclaimer: I am NOT a Clinician and cannot accept insurance.

Name(Required)

First Last

Email(Required)

WHAT IS YOUR FIRST RESPONDER STATUS?(Required)

Active

Former

Retired

WHAT IS YOUR FIRST RESPONDER FIELD?(Required)

LAW ENFORCEMENT

FIRE

EMS

CORRECTIONS

DISPATCH

HOW MANY YEARS HAVE YOU BEEN IN PUBLIC SAFETY?(Required)

0-3

4-8

9-14

15+

WHAT ARE YOUR BIGGEST STRUGGLES CURRENTLY? Check all that apply(Required)

BURNOUT

EXHAUSTION

OVERWHELM

DISCONNECT

MENTAL FOG

RECOVERING FROM A CRITICAL INCIDENT

PERSONAL LIFE

I want to work on personal growth

I am peer support and want to be more solid for others

I am in a leadership role and want to advocate for my people

Not really sure

WHAT BEST DESCRIBES YOUR CURRENT SITUATION?(Required)

I’m at the beginning of my healing journey

I’ve already done some healing work

I’ve done a lot of healing work but want to explore more!

TELL ME WHY YOU’RE INTERESTED IN THE BEAT THE BURNOUT PROGRAM:(Required)

Are you currently having thoughts of harming yourself or anyone else?(Required)

Yes, myself

Yes, someone else

On occasion

No

Previously but not currently

If comfortable sharing, have you ever been diagnosed with any kind of mental illness? If so, list below.

Please type "I [Your Name] Acknowledge" to confirm that you understand that coaching is not a substitute for working with a mental health clinician.(Required)