ILUMINA Inner-Alchemy Application

Hello and thank you for your interest in working together! Please fill out the following application to be considered for a consultation. Depending on the time of year, my 1:1 work may be on waitlist. Spots open regularly and are offered first to those who have submitted an application.

This 1:1 container provides you with a custom designed mentorship to open you to your potential and renogiate blocks that may appear along the way. My practice is rooted in the principles of integrity, curiosity, compassion, and consistency. Depending on your unique situation, a shorter term (3-month) or longer term (6+ months) package may be recommended to you. ILUMINA is generally is not a single session type of practice, as your system needs time and space to feel safe and land in connection.

There are no "right" or "wrong" answers to the following questions, so please simply answer them as thoroughly as possible to be considered.

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

How do you prefer to be contacted?

Where do you live?*

Preferred Format:*

In-PersonVirtual/OnlineNo Preference

What is your website (if you have one)?*

How did you hear about ILUMINA?*

Please tell me a little about you (hobbies, passions, career, goals, lifestyle etc). What inspires you and lights you up?*

What do you see as your biggest obstacles to having what you want? (Please list a minimum of 3 here)*

Describe your goals and what you are hoping to achieve from our work together. What would it mean for you to achieve this?*

This process requires your emotional, financial, physical commitment to staying consistent, showing up and committing to yourself with patience and compassion. Are you ready to commit to yourself?*

YesNot sure