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Apply for the Program

Build the predictable
foundation your business
needs to scale.

Complete both assessments below, then book your Breakthrough Discovery Call. Your responses go directly to our team so every conversation is focused and personalized from the start.

ADHD Checklist

Intake Survey

Book Your Call

Step 1 of 2

ADHD Symptom Checklist

Based on the Adult ADHD Self-Report Scale (ASRS-v1.1). Takes about 2 minutes. This is not a diagnosis — it's a starting point for our conversation.

First Name *

Last Name *

Email Address *

For each question, how often does this occur?

NeverRarelySometimesOftenVery Often

1. How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?

NeverRarelySometimesOftenVery Often

2. How often do you have difficulty getting things in order when you have to do a task that requires organisation?

NeverRarelySometimesOftenVery Often

3. How often do you have problems remembering appointments or obligations?

NeverRarelySometimesOftenVery Often

4. When you have a task that requires a lot of thought, how often do you avoid or delay getting started?

NeverRarelySometimesOftenVery Often

5. How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?

NeverRarelySometimesOftenVery Often

6. How often do you feel overly active and compelled to do things, like you were driven by a motor?

NeverRarelySometimesOftenVery Often

7. How often do you make careless mistakes when you have to work on a boring or difficult project?

NeverRarelySometimesOftenVery Often

8. How often do you have difficulty keeping your attention when doing boring or repetitive work?

NeverRarelySometimesOftenVery Often

9. How often do you have difficulty concentrating on what people say to you, even when they are speaking to you directly?

NeverRarelySometimesOftenVery Often

10. How often do you misplace or have difficulty finding things at home or at work?

NeverRarelySometimesOftenVery Often

Your responses are confidential and used solely to tailor your experience.

Step 2 of 2

Entrepreneur Intake Survey

Help us understand your business, your challenges, and what you're working toward. This makes your discovery call focused and genuinely useful from minute one.

In one sentence, how would you describe your business and what you do? *

What are your top 3 goals for this quarter? *

What are the biggest bottlenecks currently slowing down your business growth? *

Which areas of your business are most affected by your ADHD symptoms? (Select all that apply)

Consistency and routineSales and follow-upsContent creation or marketingOrganization and systemsTime management and schedulingPlanning and long-term strategyFinancial trackingTeam management

Which ADHD-related challenges do you experience most in your day-to-day work? (Select all that apply)

Difficulty focusing or staying on taskProcrastination or task avoidanceTrouble finishing projectsOverwhelm / decision fatigueTime blindness / poor time estimationDisorganizationImpulsivityBurnout cycles

Do you currently have an ADHD diagnosis? *

Yes, formally diagnosedI strongly suspect I have ADHD but haven't been diagnosedI'm unsure but relate to many ADHD traitsNo

What have you already tried to improve your productivity, focus, or business systems?

What stage is your business currently in? *

Idea stageEarly stage (0–1 year, building foundation)Growing (consistent clients/revenue)Scaling (team, systems, or expansion)

Which range best reflects your current average monthly take-home income from your business? *

$0 – $1,000$1,001 – $3,000$3,001 – $5,000$5,001 – $10,000$10,000+

What specific support or guidance would you most like help with right now? *

If this program worked perfectly for you, what would be different in your business and daily life 90 days from now? *

Phone number (optional)

All responses are confidential and used solely to improve your experience and outcomes.

✓

Applications received — thank you.

Your responses have been saved to our team. The last step is to book your Breakthrough Discovery Call. Pick a time that works for you below.

Book Your Discovery Call

Limited spots available. Calls are held via Zoom.

8 × 1:1 Coaching Sessions

HeartMath HRV Monitor (included)

Personalized Performance Playbook

12-Month Community Access

Monthly Group Integration Calls