Name
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First Name
Last Name
Email
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Phone
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Location/Time Zone:
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How did you find me?
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YOUR PATTERN
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What’s the pattern you know you’re done performing, even if you don’t fully understand it yet?
The one that’s still running your money, your voice, your love life, or your health?
What have you already tried to work on this?
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(List any modalities, mentors, books, therapy, tools, etc.)
What’s it costing you to keep looping this?
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(Not just financially: think capacity, connection, peace, physical wellbeing)
Complete this sentence: “I keep finding myself…”
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(e.g. “I keep finding myself freezing in hard conversations,” or “I keep finding myself running from the safe and stable men”, etc.)
YOUR READINESS
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On a scale of 1–10, how willing are you to see the parts of yourself you’ve tried to exile?
(10 = Fully willing, 1 = Not at all)
If I tell you your biggest problem isn’t what you think it is, how will you respond?
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What typically happens when someone reflects a pattern you haven’t recognised yet?
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Have you ever found yourself pulling away from a mentor when things got intense, or making them ‘wrong’ to avoid discomfort?
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Are you prepared to be met in truth, not coddled, not agreed with, but met cleanly and clearly?
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What are you hoping will be different after this work?
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THE WORK ITSELF
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Which Unruled™ pathway are you considering?
(Note: All pathways include 2 x 45-minute Zoom sessions per month + weekly WhatsApp coaching support Monday–Thursday)
Is there anything happening right now that could impact your ability to commit fully to this work?
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Have you read the Terms of Service and the Client Waiver & Informed Consent?
You must read these pages in full before applying
https://www.holliewild.com/terms-of-service-for-sessions
https://www.holliewild.com/client-waiver-informed-consent
FINAL CHECK-IN
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Why me? Why now? What made your system say yes to this?
Anything else you want me to know?
