RE:COGNITION

1
What's your name?* This field is required.
First Name
Last Name
2
What's your Email address?* This field is required.
example@example.com
3
What's your social media handle?* This field is required.
4
What are you looking to work on right now?* This field is required.Tell me the ways in which you're feeling called to transform:
5
Tell me about some risks you've taken in the past that led to success:* This field is required.
Huge
Large
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Ok
Ok
6
In what ways would you now like to honour your truth on an even deeper level?* This field is required.
7
What's blocked you from creating a soul-led life over the past few years?* This field is required.
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Large
Normal
Small
Ok
Ok
8
... and what what makes you want to work with me to clear these blocks?* This field is required.
9
Have you been diagnosed with any mental health problems? If so please state:* This field is required.Or just write no in the caption box
10
Are you currently taking and prescription meds? If yes, please state below:* This field is required.Or just write no in the caption box
11
What's your budget for 1:1 self development work?* This field is required.If under $4000, book a single clearing session and we can go from there
$4000 - $6000
$6000 - $8000
$8000 - $10,000
$10k+
Should be Empty: