Our Services Manifestation Coaching Form Our Services Manifestation Coaching Form Please enable JavaScript in your browser to complete this form.Name *FirstLastHow you prefer to be addressed.Phone *Email *How did you hear about me? *If referred, who can we thank for connecting you with us?Please select the service you are requesting.Scheduling my first matchmaking and coaching sessionMental Health Support ServicesDo you currently reside in the Dallas-Fort Worth Metroplex?YesNoPlease note: Mental health support services are only available to residents of the Dallas-Fort Worth Metroplex. If you reside outside of this area, we are unable to process your inquiry at this time. Please select your insurance provider---Insurance Provider (if applicable)---Insurance: Community-Based Plans (Medicaid/Superior/Molina)Insurance: Private (BCBS/Aetna/Cigna/United)Currently, we are only accepting a limited range private insurance providers for our mental health support services. Unfortunately, your provider is not accepted at this time. What specific concerns or areas of support are you looking to address? *Briefly describe what’s on your mind (e.g., anxiety, life transitions, grief, or relationship dynamics).Referral Consent *Yes, I authorize a representative from Hands of Hope to contact me regarding intake and services.I am a Qualified Mental Health Professional (QMHP) with Hands of Hope. I may assist with intake and care coordination. A member of our clinical team will review your information and follow up to complete intake process.Are you willing to learn new things and approach this experience with an attitude of openness and willingness? YesNoMaybeWhich option below is most conducive to feeding a fabulous focus for you?Specific goals/action items energize me and help me focusI feel greater ease with more general/flexible ideas and intentionsIt varies depending on my current situation or vibeI'm not sure, but I'm open to discovering which works best for mePlease confirm if you are comfortable with receiving readings as part of this process?YesNoThe service I offer includes the use of oracle cards to offer further guidance and support in various aspects of life, some of which you might be aware of and others you might not. It serves as a self-improvement instrument that helps clients to break free from certain behaviors and patterns, enhancing their self-awareness and improving their prospects of maintaining any relationships they form. This can cover a range of topics such as love, finances, marriage, work, and more.How much exposure have you had to Law of Attraction (LOA)? *NoneNew to AllowingSome UnderstandingReally Get ItWhich Coaching Are You Interested In? *Individual Coaching VirtuallyLaw of Attraction -Live Group VirtuallyBreakthrough SessionVirtual Date Coaching with MatchmakerCoaching is reserved exclusively for our active matchmaking clients. If you're interested in working with us, please schedule a consultation to get started.What day(s) do you feel the most energized and have the greatest ability to focus?MondayTuesdayWednesdayThursdayFridaySaturdaySundayOn the day(s) selected, what part of the day are you most energized and focused? *morning, afternoon or eveningsWhy do you feel coaching will benefit you right now and what results would you like to experience?Are you dealing with a specific issue right now? Love/Finances/Career/Family, etc.When do you want schedule your session?DateTimeLeave Blank if you are registering for our workshop. Submit
