The Initiation Application
Please fill out this form to the best of your capacity. It is 100% confidential.
Full Name
First Name
Last Name
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
Where are you located?
Why are you feeling the call to be initiated into your most empowered self?
What are your top 1-3 most empowering beliefs? What are your 1-3 most limiting beliefs?
What are you top 1-3 desires you wish to fulfill through the Initiation?
What are the top 1-3 challenges you are currently facing that are stopping you from from fully embodying who the f*ck you are?
Do you have a desire for plant medicine to be apart of your initiation? Either in micro or macro forms.
Yes
No
Other
How committed are you to showing up for this container on scale of 1-10 (1 is I have no capacity, 10 being I can full send in my capacity to show up for this)
Select the character traits to you feel you currently embody (if not all, that is okay, that may be a clue in how we can better support you)
I take radical responsibility over my life
Resilient
Willing to explore the emotions that are alive inside of me
Capacity to take action
Willingness to integrate the work we do together into my day to day life
I feel connected to something greater than myself
Curiosity - to approach life with wonder over judgement
Are you on any medications and do you have any diagnosed medical conditions? If so, please specify which kinds.
How much are you willing to invest in your healing and personal growth journey?
$1500-$3000
$4000-$6000
$7000-$10,000
I am willing to invest what ever it takes
Is there anything else on your heart you’d like to share before I review your application?
Submit
Should be Empty: