Spiral Application
Name
First Name
Last Name
Email
example@example.com
Why do you want to go through the Spiral?
Why is now a perfect time to make a change in your life?
What are your three biggest problems or challenges you are facing?
What area of your life do you most want to transform/improve?
What Specific behaviours do you want to make changes to in your life?
What would be an outstanding, tangible outcome for you as a result of doing this program?
What would you be seeing, hearing, feeling and doing differently when this change has been made?
Why is that important to you?
What would that give you?
What would you need to happen to be fully convinced that this change has been made?
How valuable is it to you to make this change?
Do you have any contra-indicative mental health issues? (significant past trauma or abuse, dissociative conditions, eating disorder, substance abuse, suicidal thoughts, current or recent health medication, etc.)
Submit
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