Before we dive in, take a moment to ground yourself.

This isn’t just an application—it’s the beginning of a mentorship journey designed to help you reconnect with your business and your bigger vision.

Rooted Rebuild is a space for honesty, curiosity, and deep transformation, and your answers will help us co-create a path that truly honors you from the very beginning.

Full Name *

Email *

How would you prefer to be addressed (Nick name? Preferred name? Pronouns?) (We want to honor you from the start.) *

What’s your Instagram handle? (So we can stay connected + follow your journey.) *

Tell us where you're at in your business right now. (What do you offer? Who do you serve? What does your day-to-day look like?) *

What’s currently not working for you in your business—or in how you're showing up to it? (Go as deep as you’d like. No wrong answers.) *

What do you want your business to feel like on the inside? (Your body, your breath, your calendar—what would alignment feel like?) *

What called you to Rooted Rebuild? (Was it a feeling? A moment? A knowing? Let us in.) *

Which part of this journey are you most excited or curious about? *

Astrology

Human Design

HypnoBreathwork

Pelvic Steaming + Sound

Strategy & Rebuilding

All of the above

What makes now the right time for this rebuild? (Why not later? Why you, why now?) *

Are you available to show up fully for this container (weekly live calls, deep mentorship, and collaborative support for 6 months)? *

Yes - I am ready to prioritize this season of rebuilding

I am nervous but I know this is right

I am unsure and open to a conversation

If it feels aligned, are you open to having a call to explore next steps? (This is a no-pressure space to ask questions and feel into the fit.) *

Yes - I'd love that!

I have questions I'd like to ask

Anything else you'd like me to know before we connect? (This is your space. Bring your truth.) *

Did anyone refer you? If so, who? *