Application · Free Consultation

Thank you for your interest in working with me.

I read every application personally and reach out only to the people I believe I can genuinely help - whether through 1:1 coaching or THE BREATHWORK MASTERCLASS.

This isn't a sales call. It's a conversation to see if we're the right fit.

Please take a few minutes to answer honestly. The more I understand where you are, the more useful our 20 minutes together will be.

- Dominique

Section 1

About you.

01What's your name?

02Email address

03How old are you?

Under 2525-3435-4445-5455+

04What do you do for work?

One line is enough - I’m getting a sense of the life you’re navigating.

Section 2

What's actually happening.

05Which of these sound most like you right now?

I wake up tense before the day has even startedOne conversation can derail me for hoursI react faster than I want to, then spend time recovering from itI’m tired but I can’t actually rest - my body won’t come downI’ve done the inner work and still feel stuck in the same loopI know exactly what my pattern is, I just can’t seem to stop itI’m functioning well on the outside but something inside is quietly burning outOther (please specify below)

Select all that apply.

Section 3

What you've already tried.

06What have you already tried to work on this?

Therapy (past or current)MedicationMeditation / mindfulness appsYogaBreathwork (casually or in classes)CoachingSelf-help books / podcastsJournalingPlant medicine / psychedelicsNothing structured yetOther (please specify below)

Select all that apply.

You'll hear back from me personally within 2-3 business days.