Liberate Mentorship Questionnaire
Name
First Name
Last Name
E-mail
example@example.com
Phone Number
-
Area Code
Phone Number
Please provide your birth information (time, date, location) for your Human Design Reading
Who are you? Please provide some brief background about you that you feel is relevant to your work in this container?
Have you done any self-growth, personal development, spiritual development in the past? How has it served you?
What drew you to Liberate Mentorship and why do you specifically want to work with me?
Do you know that liberation is possible for you?
Do you believe that liberation is possible for you?
What does liberation look like to you? (Ofc knowing this can and gets to change)
What do you perceive to be holding you back or blocking you from feeling what you wrote above?
Are you willing to go into the depths (ie. shadow work, personal history, etc) to reach higher levels of self-growth and expansion?
Does it feel expansive and exciting to enter into this space in the capacity that meets your needs? Or, does it feel scary and restrictive?
What are your specific goals and intentions for this co-created, intimate 1:1 Liberate Mentorship container? What do you desire to focus on?
What are you most excited for in our work together?
Is there anything else that you would like me to know or to ask?
Which container best suits your current needs and capacity (financial, time, commitment, experience)?
3 Month PIF - $1111
3 Month Payment Plan (3x $444)
6 Month PIF - $2222
6 Month Payment Plan (6x $444)
12 Month PIF - $4444
12 Month Payment Plan (12x$444)
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