HG Application

Full Name *

Email *

What's your IG Handle? *

What is your phone number with a country code (Canada or USA is +1-xxx-xxx-xxxx ) so we can send out a call reminder. *

Where did you find Jes / how did you hear about Jes? *

Are you currently pregnant (how far along) or planning to get pregnant? (what is your timeline to get pregnant?) *

Are you currently experiencing or have you experienced HG during pregnancy? *

I had HG in a past pregnancy

I had severe morning sickness previously

I am currently struggling with this

How committed are you to trying new strategies for preventing or reversing your morning sickness symptoms? (scale of 1-10) *

Are you actively looking for a real solution, or just exploring options right now? *

In order to best support you, please select the most appropriate option below *

I am not currently in a place where I could financially invest in support

I am financially limited, but I am willing to invest some funds/savings toward support that would help me make progress

I'm ready and willing to invest in personalized support as my health is a priority

Is there anything that would stop you from getting started right away? *

Are you the primary decision-maker for your health investments, or do you need to consult a partner? *

I am able to make decisions independently

I would want time to consult my partner

If you would want to consult with your partner, please book a call in a time slot where you are both available to be on the call *

Okay, I understand and will have him here for the conversation

There isn't a time where he can make it

Please note, we only offer a few of these calls for FREE each week to support the women in my community and spots are highly desired. If you can no make your time, please send me a message via email or DM on IG to inform me you cannot make it. *

Yes I respect your time