APPLY TO WORK WITH ME

Thank you so much for your interest in working together. As your Anxiety Coach, I’m here to provide support as you embark on this transformational journey. Please answer the questions with as much detail as possible. There are no right or wrong answers. Rather, this is an opportunity for me to get to know you a bit better. Following your submission, you'll be led to my calendar where you can book a quick call with me where we will see if we are a good fit. If you don't see a time that works for you, you can email me directly at hello@robinback.co.

*Please complete this form only if you are serious about working together and are ready/able to make the investment. With a limited number of 1:1 coaching spots available, it's important that this application is reserved for those ready to start if accepted. Thank you.

First Name

Last Name

Why did you choose to reach out to me to support you?

What are you hoping to gain from working together? Please be as specific as possible.

What have you tried so far to manage your anxiety? (Ex. meditation, breathwork, CBT, EMDR, talk therapy, somatic therapy, psychiatric medications, etc.)

Have you ever worked with a coach before? If yes, what was your experience like?

While I (Robin) am a Registered Social Worker/Licensed Therapist in the province of Ontario, I am not acting within this professional capacity through this coaching program. At no point will I be acting as your therapist during your participation in this program. Further, the service I am providing here is not therapy and shall not be considered therapy.

Yes, I understand and consent

No, I do not consent

Are you ready to make a premium investmet in yourself and your succes?

Yes, I understand the value of an investment.

No, I'm not ready to invest.