Single Session Intake

Thank you for taking the time to share a little more about yourself here in this intake form.

I appreciate your time and I look forward to learning about you.

Name

First Last

1. What is your main intention in meeting with me for private mentoring?

2. What has been holding you back from completing the ROCK STEADY Program?

3. What are your current daily practices or rituals?

4. What is your current relationship to your Soul (please choose a different word for this if ‘Soul’ doesn’t quite feel right to you), your mind and your body? Do you trust yourself? Do you listen to your inner parts talking to you?

5. In what ways and how do you feel that you offer yourself the gift of being deeply seen, heard and understood? If we use the metaphor of a phone call, when your mind, body or Soul is calling you, describe how you react or respond to each call? How do you even know when parts of you are calling for your attention? What happens? Notice that you may respond to yourself differently on different days etc. (This is a fluid reflection with no right or wrong answers, please use this reflection as a portal for self-discovery and answer as honestly as you can.)

6. Are you aware and comfortable with the fee for an Initial Consultation, to discuss your diagnosis, symptoms and implementation of neuroplasticity? (AU$1,000)?

7. How many sessions would you ideally like to book? Given the cost of each session, does this feel like a reasonable and nourishing investment for you? When would you like to get started?

Thanks again for your time and for sharing with me the potential tenderness that may have arisen as you responded to these intake questions. I will be in touch shortly.

For the meantime, please be aware that I currently offer only one session per week on Wednesday morning (this could be a Tuesday afternoon in the Northern Hemisphere). I will do my best to accommodate for your time zone, however I mostly offer times between 7am and 1pm Melbourne time.

Warmest,
Joey