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Coaching
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Mediumship
Sacred Space
Blog
Specials
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Living Inspiration
Book
Mama Guru
One ♥ Medium
Sacred Soul Coaching Intake Form
Name
*
First Name
Last Name
Email
*
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Date of birth
Occupation
How were you referred?
HEALTH
Have you had any mental, emotional, or traumatic events in the last 5 years?
Are you on any medications? Please describe.
Are you being professionally treated for any mental health challenge or addiction recovery program now or in the last 5 years? If so, what is the nature of your treatment.
Do you actively participate in daily/weekly exercise, meditation, yoga, or any other physical activity? If so, how many times a week?
SACRED SOUL GUIDANCE QUESTIONS
What changes are you wanting to make in your life?
What are top three values do you hold the most important in your life?
What kind personal growth work or spiritual work have you done? (Therapy, life coaching, group counseling, recovery programs, classes, or workshops of any kind)
Where do you feel stuck in your life?
What area in your life are you wanting to focus your spiritual guidance session on?
What do you like most about your life and what do you like least?
What are your current self-soothing or coping skills in stressful or challenging times?
When is the last time your received bodywork such as massage, acupuncture, craniosacral or energy work?
What inspires you?
What are your personal interests or hobbies?
If you are interested in a sacred soul coaching program please continue to answer the questions below.
How do you feel a spiritual coaching might benefit you?
On a scale 1-10 how coachable are you?
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What resonates with you about the Sacred Soul Coach methodology?
What has stopped you in the past from being able to effectively make a lasting change in your life?
Rate your life 1-10 (1 least to 10 most)
Personal
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Relationship
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Family
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Spiritual
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Health
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What is a dream you pursued that worked out? What is a dream you pursued that did not work out?
Are there any questions that you would like to ask?
Thank you!
