The Healing You Intensive Shadow Exploration

The Healing You Intensive Shadow Exploration

Participant Assessment
Name:

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Phone Number*
Why is NOW the time for you to take action, towards your transformation?
Please tell me what you would like to gain from this program?
How will you know you’re getting what you want from this program?
What life transitions or challenges are you experiencing at this time?
What (if any) emotional or physical trauma have you experienced?
What is your spiritual or religious orientation?
Is there anything else you'd like me to know about, before we begin our journey together, so that you can enjoy this program as much as possible?
Signature and Date
Warmly and with excitement for our upcoming journey together,

Gloria
Should be Empty: