Welcome!

Thank you for your interest in our holistic consulting services. Please take a few moments to complete this confidential questionnaire. Your responses will help us better understand your needs and how we can support your healing and growth journey.

Full Name*

Preferred Name (if different)

Pronouns

Email Address*

Phone Number*

Preferred Method of Contact (Email, Phone, Video Call, Other)*

What’s your main reason for seeking holistic consulting? (e.g., emotional healing, life clarity, stress relief, spiritual guidance, etc.)

What’s one challenge you're currently facing that you want to work through?

What are your top 1–2 goals for your healing or personal growth right now?

Have you worked with a coach, therapist, or healer before?

Yes

If yes, what worked or didn’t work for you?

Are you open to spiritual or mindfulness-based practices (e.g., breathwork, energy work, meditation)?

Yes

Not Sure

On a scale of 1–10, how ready are you to invest time and energy into your healing journey? (1 = Not ready, 10 = Fully committed)

How would you prefer sessions to feel? (e.g., structured, open-ended, spiritual, practical, deeply reflective, etc.)

Is there anything you'd like me to know about your lived experience or identity that will help me hold space for you better?

What does support look like for you right now?