Name
*
First Name
Last Name
Colors:
*
What color or colors feel like "empowerment" or "empowering" to you?
Empowering Scents:
What scents smell like empowerment or feel empowering to you?
Taste or food/drink:
What tastes or food/drink feel like empowerment/empowering to you?
Tactile/Touch:
What tactile texture or material (e.g., silk, earth, water, metal) feels like empowerment or empowering to you?:
Sound/Music:
How about an empowering sound or piece or style of music?
Colors:
What colors would you associate with unconditional love?
Scents:
What scents call up the feeling of unconditional love for you?
Taste/Food/Drink:
What tastes or food or drink would you associate with unconditional love?
Tactile/Touch:
What tactile texture or material (e.g., silk, earth, fuzzy, soft) feels like unconditional love for you?
Sound/Music
How about a sound, piece of music, or style of music that helps you feel a sense of unconditional love?
Colors
What colors feel like safety or make you feel safe and protected?
Scents:
What scents call up a feeling of protection or being grounded and safe?
Taste/Food/Drink:
Do you have any tastes or food or drink make you feel safe and grounded?
Tactile/Touch
Do you have anything that you can touch or feel that would make you feel safe or protected? For instance, I love to feel the bark of a tree, or grass under my feet. How about you?
Sound/Music
Is there any piece of music, sound, or style of music that makes you feel safe or protected?
Colors:
Is there a color or colors of deep, empowering truth for you?
Scents:
Is there a scent of feeling uplifted or in alignment with your truth?
Taste/Food/Drink
Do you have any tastes or food or drink that are uplifting, celebratory, and feel like you are in alignment with your deepest truth?
Tactile/Touch
What tactile feeling would be uplifting or feel like you were deeply celebrating you being in alignment with your truth?
Sound/Music:
Do you have any sounds, a piece of music, or a style of music that feels like it's a celebration of being in alignment with your truth/intuition/identity?
Body sensation:
We will work on this one, but do you have any particular body sensations (e.g., chills, warmth in chest) when you are getting a hit of intuition or a truth bomb coming in?:
Words/Phrases
Do you have any symbols or phrases that represents truth for you? Again, we will be working on this one to get you in deep alignment, but if you have something that resonates now, let me know:
🎧 LEARNING STYLE
How do you best absorb transformational content?
(Choose all that apply .)
Audio (e.g., voice recordings, music, meditations)
Visual (e.g., diagrams, images, written words)
Movement-based (e.g., embodiment exercises, dance, somatic work)
Hands-on / experiential
Reflective / journaling
Conversational / live coaching or discussion
✨ PERSONAL ALCHEMY
What helps you feel most YOU?
(Complete the sentence or list anything that comes to mind.)
What’s a non-negotiable for you when it comes to healing spaces?
(e.g., warmth, depth, playfulness, privacy)
Is there a phrase, image, or symbol that captures the transformation you’re stepping into?
If not, feel free to make one up—it can be poetic, primal, or playful.