The Evolved Woman

Nervous System Elixir Program

APPLICATION

Please complete the below questions to apply for a space in this program. Once submitted we will contact you within 3 business days regarding your application.

Program Outline

*Intakes close 26th September 2025

*Spaces are very limited

Name

First Name

Last Name

Phone

(###)

###

####

What motivated you to apply for The Evolved Woman Program?

Describe your current personal and professional situation.

Which specific areas in your life are you looking to transform or expand on through this program?

Have you previously participated in personal development programs? If yes, share your experiences.

On a scale of 1-10 how willing are you to invest into your expansion, body, mind and spirit?

If you could overcome one specific challenge through this program, what would it be?

What would it mean to you to find a deeper sense of trust and of safety within your body and nervous system and in connection with supportive women?

Are you committed to fully engage in the program and embrace the teachings and practices?

If you are accepted into this program what would be the first step you take towards your unique transformation?

What changes do you hope to see in your life in the 10 week journey of The Evolved Woman Program?

How important is it to your to improve you skills in setting boundaries without feeling guilty?

Do you have any specific dietary requirements for our half day retreat? (if attending the in person)

Do you currently experience symptoms of PTSD, C-PTSD, anxiety, depression or other mental health concerns? If so, please share.

Do you have any medical conditions or are you taking any regular prescription medication that you feel is relevant to the program? If so, please share.

Is there anything you are aware of that could hold you back from fully engaging in the program?

Are you ready to prioritise you and connect with your unique feminine essence so you can pour from a full cup?!

Do you have any questions regarding the program or is there anything more you'd like to share about yourself?

THE RIPPLE EFFECT MVMT

Sunshine Coast, QLD.