Embodied Truth Session — Private Intake Form

Embodied Truth Session — Private Intake Form
Hi love,

Thank you for booking an Embodied Truth Session with me.

These sessions are a contained, private space for people who feel something shifting and want support orienting inside it — without being told who to be or what to do.

Please take a few minutes to complete this form thoughtfully. Your responses help me understand where you are in your process and how to hold this space with clarity and intention.

All information shared here is confidential.
Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
What currently feels like it’s shifting, unclear, or in transition for you?*
If you had to name the core tension underneath everything right now, what would it be?*
What do you feel you need most right now? (choose up to two)*

ClarityValidationDirectionStabilizationIntegrationSomething I can’t quite name yet
Have you received intuitive, coaching, therapy, or spiritual support before?*

YesNoA mix
Are you currently experiencing acute mental health crisis or instability?*
If yes, please note: these sessions are not a replacement for licensed mental health support.
Do you consent to me tuning into your energy and spiritual guidance for purpose of this session?*
Would you like to receive updates about workshops, circles, and future offerings?

YesNo

Private Containers*

Embodied Truth Session — 75 Minutes

Private orientation + integration container

$155.55

Enter coupon

Total

$0.00

Session Policies

By booking this session, you agree to the following:

Time Zone: All sessions are scheduled in Pacific Time. Please confirm your time zone before booking.

Punctuality: Sessions begin promptly. A 10-minute grace period is allowed.

Rescheduling: 24 hours notice required.

Refund Policy: Sessions are non-refundable. Rescheduling must follow policy above.

Availability: I offer a limited number of sessions per week to keep this work grounded and present.

Disclaimer

These sessions are for spiritual reflection and personal insight purposes only. They are not a substitute for medical, legal, financial, or psychological advice.

By booking, you acknowledge full responsibility for your personal decisions and integration.
CONSENT + CONTAINER

Consent to Session*
I understand this session is a reflective, intuitive, and embodiment-based guidance space.
I understand this is not therapy, medical, legal, or psychological treatment.
I take responsibility for my own decisions and integration
Please check the following to confirm your understanding and alignment:*

I understand that this is a Spirit-led space, and I trust Simone to deliver what is meant to be received.I acknowledge that Simone is a spiritual guide, not a therapist, and this session is not a substitute for mental health care.I understand that Simone may decline or reschedule this session if the energy does not feel aligned.I understand that forming personal, para-social, or codependent attachments to Simone is not appropriate. I respect her boundaries.I agree to show up with openness, respect, and trust. I will release expectations and allow Spirit to lead.
I have read and agree to these terms, policies, and I consent to move forward.*

Yes, I agree.
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