Beyond Your Brain Program Interest Form
Beyond Your Brain (BYB) is a comprehensive set of personal and spiritual experiences designed to help you build self-trust, deepen self-awareness, and create meaningful change in your life. This assessment helps us understand where you are right now—and what would best support you on your journey. Take a few moments to answer honestly. Your responses will guide us in recommending the most aligned next step for you.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What would you like to release/let go of/increase/gain/learn or change?
*
Please describe your experience to date with mindfulness/meditation/stopping thoughts.
*
Please describe your experience to date with synchronicity/serendipity, divine guidance, mystical experiences, ease of manifestation, intuition, grace, lucid dreaming, connection with the unseen worlds.
*
Do you have any physical health conditions that would prevent you from sitting for long periods of time and light hiking?
*
Do you have any emotional health conditions that would prevent you from fully participating (or would cause discomfort)?
*
Describe the type of leader that you are. How would you like to evolve your leadership instincts and skills?
*
What are your top 3 priorities in life?
*
What is your primary spiritual belief system (religion or if none, spiritual practice beliefs)?
*
Part of this program involves a commitment to yourself and others by embracing a retreat mindset and setting aside external cell phone and computer communications. Please describe what level of commitment or challenges you anticipate related to setting aside external communications.
*
This program is certain to challenge long-standing belief systems or perspectives of yourself, your relations, and your environment. Please describe any practices that you currently have or preparations that you will engage in, in advance, to open yourself up to the unexpected, cultivate a non-judgmental level of curiosity, and enable you to receive new possibilities on how to thrive as a leader through this work.
*
What type of support are you most open to right now?
*
Self-paced courses or guides
Deep immersive experiences (2-3 day retreat)
1:1 personalized support
Live workshops or short programs
If you were to invest in yourself right now, what feels most aligned?
*
Free resources only
Low investment ($50–$500)
Mid-range programs ($500–$2,000)
Premium experiences ($2,000–$4,000+)
How did you find us (socials, referral, current client, newsletter, etc)?
*
Submit
Should be Empty: