TCW 16 week questionnaire | paolabaharavcoach

Thank you for your interest in Connected Within!

This application helps me understand where you are in your journey, what you're seeking support with, and whether this experience is the right fit for you.

Please answer each question as openly and honestly as possible.

First name

Last name

Email

Phone

What inspired you to apply for Connected Within at this point in your life?

What are the biggest challenges or patterns you are currently experiencing?

What areas of your life feel most affected by these patterns?

What would you most like to create, experience, or feel differently in your life?

What would success look like for you at the end of the 16-week journey?

What practices, if any, do you currently engage in for personal growth or mindfulness? (e.g., journaling, meditation, therapy, coaching, breathwork, yoga, etc.)

What patterns or limiting beliefs do you notice repeating in your life that you’d like to transform?

The Connected Within Program involves inner work, holistic and neuroplasticity practices, and emotional reflection. Are you ready to dedicate time each week (approximately 80 minutes for live sessions plus 20–30 minutes for personal practices)?

Yes, absolutely

I’m willing to commit

Not sure yet

Other

Which of the following outcomes resonate most with what you hope to gain? (Select up to three)

Healing past emotional wounds

Gaining clarity about my next chapter

Building self-trust and confidence

A deeper connection with myself

Creating healthier boundaries and relationships

Continue my personal growth

What is your biggest intention for joining the Connected Within

How would your life change if you felt more self-connected, grounded, and at peace within yourself?

Is there anything else you’d like Paola to know about you or your journey before starting?

Connected Within

16-Week Group Program

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