Concierge Discovery Form — Journey Guide Project

Let’s Explore Your Journey Together

Concierge Program Discovery

Thank you for your interest in the Journey Guide Project Concierge Program. This discovery form is the first step toward building a supportive, ongoing relationship tailored to your unique needs. Your responses will remain confidential.

The Concierge Program offers up to 12 hours per year of personalized support, helping you make sense of medical decisions, tend your mind-body connection, and move forward with confidence. The annual fee is $5,000. Completing this form does not commit you to anything—it simply begins a conversation about whether this offering is the right fit for you.

We’ll use your responses to better understand your experience and values. Once submitted, someone from our team will personally follow up with you to answer questions, share more details, and discuss next steps.

Name

First Name

Last Name

Email

Phone

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What kind of guidance or support are you looking for right now?

What emotions arose when you received your diagnosis or began managing your health concerns?

What do you wish your care team knew about you that would help them provide more meaningful support?

What would you hope to gain from a relationship with the Journey Guide Project?

How would you prefer we follow up with you?

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