Application for Personal Coaching

Welcome to Think. Feel. Change! Coaching, and thank you for your interest!

Please fill out the form below in its entirety, and be sure you have read and are in agreement with the Private Session Agreement. The questions below will allow me to understand your needs so as to best serve you and accommodate scheduling across time zones.  

Many warm wishes,
Jean Erickson
Change & Success Coach

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(Medical, modalities, psychiatric, pharmaceutical, etc)
Please explain any special time or package customization requests here.
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If YES, please include a name.
The only discounts honored are those published on my website: I reserve the right to change, adjust or otherwise maintain control over packages and prices at any time and/or for any reason. Prices listed are in US Dollar.
All time slots listed in US Central Time. Type or mark your preferred or greatest availability appointment time using the time slots listed below.
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