Apply for Consultation

Mannsthiti

You don't need fixing, you need alignment.

Home About Services Contact

Consultation Application

Let's understand where you are

This form helps Dr. Priyanka understand your situation before your session. All responses are completely confidential.

Section 1 of 3

Tell us a little about you

Full Name *

Age *

City *

Email Address *

WhatsApp Number *

What do you currently do? *

Student

Working Professional

Business Owner

Freelancer

Homemaker

Other

Section 2 of 3

What's been going on lately?

What are you currently struggling with? * Select all that apply

Stress / Anxiety

Low confidence

Relationship issues

Career confusion

Emotional overwhelm

Other

How long have you been feeling this way? *

A few weeks

A few months

More than 6 months

More than a year

What do you feel is holding you back the most? * Select all that apply

Overthinking

Low confidence

Fear / Anxiety

Lack of clarity

Procrastination

Emotional pain / past experiences

Other

Section 3 of 3

Let's understand your goals

What would you like to improve or change in your life right now? *

If things don't change, how do you think this will affect you in the future? *

Where are you right now? *

Ready to take action

Exploring my options

Not sure yet, just curious

What time of day works best for you? *

Morning (9am – 12pm)

Afternoon (12pm – 4pm)

Evening (4pm – 8pm)

Are you open to investing in yourself? *

Yes, I understand quality support has a cost

I'd like to know pricing first

I have a tight budget right now

How did you hear about Mannsthiti? *

Instagram

Referral

YouTube

Other

All information shared is completely confidential.

Something went wrong. Please try again or email us at drpriyankalifecoach@gmail.com

🌿

Thank you for applying

Your responses have been received and will be reviewed shortly. You will be contacted soon to schedule your consultation.

We look forward to supporting you on your journey toward clarity, confidence and alignment.

Mannsthiti by Dr. Priyanka

Mental Health · Emotional Wellness · Personality Development

Home About Services Contact

drpriyankalifecoach@gmail.com @mannsthiti_with_drpriyanka