Entering the Space
This intake helps assess readiness, capacity and fit.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
I am interested in the following containers:
Individual Sessions
Group & Collective containers
Psychedelic & Entheogenic Integration
Womb Rites
Experience with Altered States: Have you worked with psychedelics or non-ordinary states before? Say more
Intention & Readiness: What is drawing you to this practice at this time? What are you hoping will change as a result? How do you currently support your nervous system and integration in daily life?
Health Background: Have you ever experienced psychosis or dissociation? Are you taking any medications? If so, which ones?
Is there anything important for me to know about you and your journey? (This can be anything else about what you hope to learn with non-dual experiences, and how you hope it will enrich your life)
Submit
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