BOOKING

Introductory client form

*Due to high volumes, please expect a slight delay between enquiry and session booking.

Name

First Name

Last Name

Phone number +Country Code

Country

Time zone

Is there anything specific you'd like to explore?

Are you taking any meds or drugs (prescribed or not) that I need to be aware of?

yes

If yes, please list them.

Date of birth

Please briefly describe the moment you decided to book yourself a session. What motivated you?

Please briefly describe your journey so far with personal development; e.g.how new or experienced you are with understanding mental processes, inner work, journeying or shadow work. You may like to include brief details of if and how you meditate, journal or do emotional process work.

Are you currently aware of any emotional blocks and can you name them?

What are you feeling as you complete this form?

A year from now, how do you see yourself?

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