JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
What You Need Most Feedback Form
Thank you so much for your time! We ask for your email address only to send you a free gift as a thank you, you won't be added to any lists or receive any spam, I promise! ;)
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
In general, what type of container are you most likely to attend (select the ones you are most drawn to)?
*
90 Minute Workshop
A 3 Week Program
A 6 Month Program
A Deep Dive 1 or 2 Day Event
An In-Person Retreat
A 3 Day Free Event Online
Which issue are you needing help with most right now?
*
Stress + energy management tools
Being able to know my inner guidance and trust it
Self love, self worthiness, self care
Manifestation tools to activate higher levels of energy, magnetism and success
I'm new here and I have no idea where to start in my self growth journey
I am manifesting BIG things and need help
Other
Required
In your words, what are your biggest struggles right now in your self growth journey? What are you seeking answers or solutions to? What would you give anything to figure out or move through?
*
Your answer
In your words, what do you want more of in your life?
*
Your answer
In your words, do you feel you need right now in general?
*
Your answer
An event or short program about
Activating your Intuition
+ developing your inner guide - how much does this call you?
*
Meh
1
2
3
4
5
6
7
8
9
10
OMG I need this NOW!
An event or short program about
Healing To Manifest
- healing the core wounds and learning the lessons that have stopped you from manifesting more - how much does this call you?
*
Not for me
1
2
3
4
5
6
7
8
9
10
Yes, please!
An event or short program about
Healing Your Inner Child
- how much does this call you?
*
Meh
1
2
3
4
5
6
7
8
9
10
Absolutely, yes!
An event or short program about
Awakening HER
, manifesting with the quantum, activating your "future self" - how much does this call you?
*
Not for me
1
2
3
4
5
6
7
8
9
10
100% YESSSS
An event or short program about
Uncovering Your Purpose
- how much does this call you?
*
Meh
1
2
3
4
5
6
7
8
9
10
OMG I need this NOW!
An event or short program about
Quantum Leaping + the Rapid Embodiment Technique
- how much does this call you?
*
Meh
1
2
3
4
5
6
7
8
9
10
YES YES!
An event or short program for
Spiritual / Soul-led Entrepreneurs
about creating success, making an impact, sharing their gifts, attracting aligned clients and getting to consistent $10K months in a soul-aligned way - how much does this call you?
*
Not applicable to me
1
2
3
4
5
6
7
8
9
10
Yes, I need this!
An event or short program about
Empowering The Empath
- energy management strategies and understanding your sensitive nature and your gifts - how much does this call you?
*
I'm not an empath / not interested
1
2
3
4
5
6
7
8
9
10
Yes please!
If you could see me host an event, program or workshop on the thing(s) that would be most helpful and valuable - what would it be on?
*
Your answer
Thank you! Is there anything else you want to say, suggest or give feedback on?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Talia Dickson.
Report Abuse
Forms
