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Pattern Breaking Program Application

Ready to break free from old patterns?
 
Apply for the Choose Happy Pattern Breaker Program with Heather V Masters!
This short form takes 2-3 minutes, and you’ll be prompted to book a 15-minute discovery call afterward.

Click the button below to start.

Start

Contact Info

Your Details

Question 2 of 15

Your Details
Name, Email and Phone Number - best contact details

Your Transformational Goals

What would you like to Achieve?

Question 4 of 15

About Your Vision and Goals - Describe what you want out of the program and the next 3 months

 

What’s the biggest change or goal you want to achieve in the next 3 months? How would breaking your pattern help you get there?

Question 5 of 15

Why Are You Interested in the Choosing Happy Pattern Breaker Program?
Why are you drawn to the program? What excites you about working with Heather and using coaching, NLP, and hypnosis?

About You

Question 7 of 15

What’s Your Experience with Coaching or Personal Growth?

(Select all that apply)
A

I’m new to this

B

I’ve tried self-help books/podcasts

C

I’ve worked with a coach before

D

I’m familiar with NLP/hypnosis

Question 8 of 15

Are you committed to doing whatever it takes to achieve your outcome?

A

Yes

B

No

Question 9 of 15

Are you committed to doing whatever it takes to achieve your outcome?

1. I have time to invest in myself. 2. I can make and keep appointments with myself to work on this material. 3. There is a gap between where I am and where I want to be. 

A

Yes

B

No

Question 10 of 15

Are you willing to be coached?

1. I am fully willing to do the work required to get me where I want to go.

2. I am willing to stop or change the self-defeating behaviours that limit  my success.

3. I am willing to try new things even if I am not 100% convinced they will work. 

A

Yes

B

No

Question 11 of 15

Are you able to be coached?

1. Coaching is the appropriate discipline for the changes I want to make.  

2. I have the patience to take consistent action towards my goals, regardless of how immediate the results are.

3. I have the support I need to make significant changes with ease. (i.e. family or corporate structure) 

Question 12 of 15

If you were to know, what is the pattern that is keeping you from reaching your goals?

Tell us about the pattern or problem you’re ready to break free from. For example, is it procrastination, self-doubt, people-pleasing, or something else? How has it been holding you back?

Question 13 of 15

How did you hear about the program?

“Choosing Happy Podcast,” “Email,” “Social Media (Instagram/X/LinkedIn),” “Friend/Referral,” “Other (please specify).”

Question 14 of 15

Do you have any questions?

Question 15 of 15

Consent to Contact -  I agree to be contacted by Heather V Masters regarding the Choose Happy Transformation program and understand my information will be handled per the Privacy Policy.

A

Yes

B

No

Confirm and Submit