AI RIISmap Questionnaire

AI RIISmap Questionnaire
We encourage this to be a very special and intentional process. All data collected from this questionnaire will be used exclusively for the purpose of creating your personalized AI RIISmaps.

Some suggestions are as follows:
- Choose a time of day when you’re well rested and have atleast 15 mins with minimal distractions.
- Take a few deep breaths and set an intention to answer the questions with an open mind and open heart, accepting anything that wants to come up.
- Be as thorough and honest as possible. The more you share the more advanced and accurate your results will be.
- Hold compassion and gratitude for yourself through the process. Use this as an opportunity to explore without judgment.
Section 1: Personal Information
Please fill this out to the best of your ability. If you do not know an answer to a question or it is not applicable, put N/A*
Please fill out handle names or links to any up-to-date social media you may have
Email*
example@example.com
Health History
Do you have any existing medical conditions? If so, please explain.
Please list any current medications:
Do you engage in regular physical activity?

YesNo
Please list any dietary restrictions or habits:
Anything else you would like to share about your health?

Section 2: Purpose Exploration
Are there things you're experiencing in your life that are inspiring you to embark on this journey? If so, please explain:
Have you embarked on an inward or spiritual journey before? If yes, please explain
Is there anything in particular you feel passionate about changing or doing in this world?
What do you feel is your unique contribution to the world? If unsure, what are some activities, skills, or interests that make you feel most alive, passionate, or fulfilled?
You are lying on your deathbed, looking back on your life, you feel satisfied and fulfilled because you did or were what? Provide as much detail as possible

How did you hear about this journey?*
Each participant will receive a customized notebook. Please provide these details:

What color do you prefer? blank*
What name would you like engraved? blank fields and text.
Upload a recent picture

Cancelof
Anything else you would like us to know?
Once payment is received you will receive an email with next steps. This includes the details about being matched to a cohort and finalizing dates/times. Most cohorts meet twice a week and every other Saturday. Most are 12 weeks long with none extending past 14 weeks. This flexibility within each cohort is important as we are all on unique journeys. Once dates/times are agreed on, we encourage a serious commitment to honor the agreement. The consistency is essential in such a powerful transformative journey!

RIIS Journey Payment Options: Choose your payment option up to 24 months. We ask the lower payment options be reserved for those who need it so there's balance in the cohorts with practitioners getting paid. There is a $30 monthly service fee included unless payment is in full.*

Pay in Full

$6,500.00 one-time payment

6 Month Payment Plan

$1,113.00 for each month

9 Month Payment Plan

$752.00 for each month

12 Month Payment Plan

$572.00 for each month

18 Month Payment Plan

$391.00 for each month

24 Month Payment Plan

$299.00 for each month

Apply for Scholarship

$ Free one-time payment

Total

$0.00

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AI RIISmap Questionnaire

Section 1: Personal Information

Health History

Section 2: Purpose Exploration

Section 3: Identifying Beliefs/Patterns

On a scale of 1 to 5, with 1 being "Strongly Disagree" and 5 being "Strongly Agree," please rate how much you resonate with each of the following:

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