I am beaming that you have said YES to this commitment for yourself. YESSSSSSS.

A commitment that will take you on a path to unravel all your truths within and with that let the peace + joy within you come flowing out into your everyday. This program will provide tools + practices that will support you to dig and uncover, revise + release root pains + stories that have been clogging your true essence. Tools + practices to support you to return back to your true self. Your best self + feel alive again.

PLEASE FILL IN THIS FORM TO GIVE US BOTH A GLANCE AT HOW WE WILL SUPPORT YOU + YOUR FULL BLOOM.

Name

First Name

Last Name

Phone

(###)

###

####

What motivated you to say YES to this program?

How would you describe your state of being in life right now (emotional/mind, body, soul)?

What would your ideal state of being look like (emotional/mind, body, soul)?

What are you hoping your state of being will look like at the end of this program (emotional/mind, body, soul)?

What has stopped you from achieving your ideal state of being in the past?

What have you used in the past to try to reach your ideal state of being?

What are your specific goals for working with me?

What 3 things would you say to describe yourself when first meeting new people?

How are you willing to commit to yourself over the course of this program?

Please add anything else you’d like to share with me.