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Embodied Alchemy One-On-One Application
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Legal Name
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Your answer
Preferred Name
Your answer
Email Address
*
Your answer
What are your goals in seeking support?
*
Your answer
What areas of life are you feeling most called to work with during this time?
Emotional Security
Relational Security
Financial Security
Career
Spiritual Evolution
Purpose
Other:
Are you currently undergoing stress or going through an emotionally strenuous period in your life? If so, what are you doing to manage it?
Your answer
How supported by your community, friends, family do you feel?
Not Supported
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2
3
4
5
Well Supported
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Have you participated in personal therapy before? If so, are you working with someone now?
Your answer
Do you have any specific concerns or questions about one-on-one work?
Your answer
What would be the best possible outcome for you as a result of participating in this transformational container?
Your answer
Do you have any financial concerns regarding the container fee?
Your answer
Anything else you'd like to add?
Your answer
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