Name
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First Name
Last Name
Email
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Phone
(###)
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What is your preferred way to be contacted?
What are your preferred pronouns?
Why are you drawn to this session right now?
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What called you to this experience?
What are you carrying lately - Emotionally, energetically, or otherwise?
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Is there a specific emotion, memory or part of yourself you want to explore in this session?
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Even if you are not sure...write first thing that comes to mind...or IDK
What Do you hope this session might offer you?
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(Release, Reflection, Connection, Softness, Clarity, etc...)
Is there anything you are afraid of or unsure about going into this session?
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Let’s name it so we can meet it with care.
What Does Safety feel like in your body?
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What helps you soften or stay grounded?
s there any part of your body, story, or identity that you’d prefer not to focus on in photos?
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You don’t need to explain—just name it if you want to.
Are you comfortable with gentle, non-touch movement guidance during the session?
Do you have any physical conditions, trauma sensitivies, or access needs you'd like me to be aware of?
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How do you usually take care of yourself after emotional release or deep processing?
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Tea, journaling, rest, nature, silence...
Is there anything you would like to receive after the session?
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Do you understand that this is NOT a replacement for therapy and has NOT been offered as such?
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Is there anything else you would like to add?