Apply To Work Together 🦋

Apply To Work Together 🦋

Please plan about 10 minutes to complete this form.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Which program are you interested in?

Medicine Ceremony1:1 Coaching/ Spiritual GuidanceHealing Work: Massage, Energy Healing, Sound Therapy, OR BreathworkCombinationNot Sure
Have we met or worked together in any capacity before (this includes courses, meditations, workshops, etc)?

YesNo
What has your primary focus in life been so far?*
What's one thing you deeply desire more than anything else right now?*
What is one big win you want in the next 12 months?*
In what area of life do you experience the most stress? What specific triggers cause this stress?*
How long have you been dealing with this challenge?*
On a scale of 0 to 10... what is the cost of this situation on your happiness?*
On a scale of 0 to 10... what is the cost of this situation on your relationships?*
On a scale of 0 to 10... What is the cost of this situation on your finances?*
Are you consciously aware of any adverse events that happened during your childhood? (Bullying, Loss of Parent/Loved One, Natural Disasters, Physical Abuse, Sexual Abuse or Emotional Abuse, etc.) *
What transformational tools have you worked with? (Meditation, Breathwork, Plant Medicine, Yoga, Journaling, etc.) *
Have you worked 1-1 with a coach or therapist before? If so, what was your experience like, and who was it with?*
Are you looking for guidance/support in a specific area? (Select all that apply)

Expanding my capacity to receive and hold wealthHealing relationship patterns & expanding my ability to give/receive loveIntegrating plant medicine or psychedelic experiencesStrengthening intuition, spiritual tools, and awakeningNervous system recalibration & emotional regulationDeepening spiritual practice & alignment with my purposeStepping into my highest leadership & impactCreating my realityOther
What psychedelics and/or plant medicines have you worked with? Are you a beginner, intermediate/advanced user, or psychonaut? What has your experience been with them?*
Are you currently taking any prescription medications? If yes, to address what symptoms?*
Tell me a bit more about your career or business. What do you do? And how do you really feel about it? Is this your life's purpose?*
Why do you feel called to work with me specifically at this time? What about my approach, expertise, or energy resonates most with you?*
How willing (10 being very willing) are you to financially invest in your personal growth and your future to achieve and embody the goals you have laid out today?*

10987654321
How did you hear about me?*
To honor the high quality of my offerings, I work dedicatedly with only a few clients at any one time. My programs vary from $5k -$30k offers. Are you prepared to dive in?*

I have the time, energy and resources to make an investment into myself, I am ready to grow and expand into the next chapter of my life!I have access to (or am willing be resourceful and find) the financial resources to make this investment in myself. I know it will be truly worth it and I will make it happen!I would like to be informed of free Masterminds and lower investment options.
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