This application form is designed to help both of us determine if this five-session package is the right fit for your journey. Please take a few moments to answer the questions thoughtfully. The goal is to ensure that this intensive will support your current stage of growth & development.

Name

First Name

Last Name

Phone

(###)

###

####

What has brought you to this point in your journey, and why are you considering this intensive?

Please share any experiences, desires, or challenges that led you to explore deeper self-discovery and transformation.

What stage of your personal journey do you feel you're in right now?

Choose the option that feels most aligned.

Other

Please explain

What specific traits, qualities, or areas of life are you currently focused on exploring or developing?

For example: courage, creativity, leadership, emotional healing, relationships, spirituality, etc

What challenges or blocks have you been experiencing in cultivating or expressing these traits?

Are there specific fears, doubts, or patterns that you'd like support with during this intensive?

How do you currently work with your body, energy, or mind in your personal growth?

Do you have a regular practice--such as meditation, energy work, journaling, or somatic exercises? If not, are you open to incorporating new practices?

Have you worked with archetypes, Tarot, somatic work, or other modalities before? If so, how have these helped you?

Please describe any prior experiences you've had with these modalities. If you're new to them, share your thoughts on exploring them.

How would you like to use these five sessions?

Select the option that resonates most, or add your own thoughts.

Other

Please explain

What outcome would you ideally like to see by the end of this five-session intensive?

What transformation or clarity would feel like success to you?

Are you ready to commit to using all five sessions within two months, and are you willing to invest the time and energy needed for personal growth during this deep dive?

This helps ensure we're on the same page about the commitment required for this experience.

I'm not sure

Please explain

Why do you feel this personalized intensive would be the right fit for you at this time?

Please share your thoughts on how this intensive can support you in our current phase of growth and transformation.

Is there anything else you feel is important for me to know about you before we start our sessions?

This can include any specific needs, questions, or concerns.

Do you have any medical or psychological conditions that might affect our work together?

List any medications or undergoing treatments that I should be aware of.

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