The Clinic Application

Are you ready to discover your magic mid-life?

‘…to carve timeout, to reinvigorate.

To close the gap – between the world you inhabit, and the one you never explored – but wish you did’.

Thank you for getting in touch. The key to working together will be if we are a good fit for each other, that’s how we can work on making positive changes.

The below information a great place to start…if I know I can help you I will be in touch with the next steps in our journey.

Love and hugs

Monique xx

About You

First Name

Last Name

Best Email Address

Best Contact Phone

Referred by

Age

What area of your mid-life is currently the biggest struggle?

Biggest Struggle

What applies to you now (1 definitely - 10 not really).

Don’t know where to start

Feel stuck and helpless

Struggle to get organised

Self esteem in the toilet

Wellbeing needs a tweak (nutrition/movement/sleep/mindfulness)

Give in to other people’s needs

Other (please specify)

Tick all that apply

Irregular working hours

Kids at home

High level responsibility at work

Lack of time

Caring for an older family member

Why is it important for you to make change now?

Importance of Changing Now **

What lifestyle tweaks have worked well in the past?

Past Lifestyle Tweaks

The Clinic Application

Are you ready to discover your magic mid-life?

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