Describe your current self
What drew you to The Spiral Program?
What change would you like to see/experience through your Spiral Journey?
What 3 challenges or issues would you most like to overcome?
What other spiritual, self development or therapies have you done in the past?
Out of the above, what has worked for you and what hasn’t?
Are you currently seeing any other mental health or spiritual practitioners? If so please specify
Have you ever been professionally diagnosed with mental illness?
Are you currently taking any prescription or recreational drugs? Please specify what and how often
Do you have a history of drug abuse? If so please specify what drug, when and for how long
Are you currently or have you been suicidal in the past?
Is there anyone in your life who actively opposes, antagonises or suppresses you?
What is the most important change you would like to experience within yourself
Describe what your best life looks like
Do you have any additional comments or questions?
Should be Empty:
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