Intake Form

THE DEEP CHANGE SERIES – LOVE, INTIMACY AND RELATIONSHIPS

THE DEEP CHANGE SERIES – LOVE, INTIMACY AND RELATIONSHIPS

Welcome to Level 1 – Opening Into Fulfilling Relationship

 

To be able to best support you on your journey through Deep Change we ask that you answer the following questions in as much details as you feel comfortable to. We understand each participant has a unique history, and unique needs.

All information provided is kept strictly confidential between you and the facilitator (Chris and Shakti). The exception to this is if we believe you or others are in serious risk of harm (and we would discuss it with you first where possible). If any of the questions are unclear, or you would prefer not to answer, you may choose to leave them blank.

It is normal during the period leading up to a powerful process like this for all sorts of emotions and memories to start stirring within us.

When we commit to a journeying process, the energy that is wanting to be owned in our lives may be activated prior to the experience, so be as gentle and compassionate with yourself as you can in the days, and weeks leading up.

Please reach out for support if you need to, or if you have any concerns or questions that you would like to talk through. The best way to do that is to send a text message to Chris on 0411 54 29 54, and we can arrange a time to chat.

 

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How long have you been in relationship?

How long have you been in relationship?

How long have you been out of relationship?

How long have you been out of relationship?

Loss

I understand and accept all of the conditions of participating in the Deep Change Series:

THANK YOU! We look forward to supporting you on your Deep Change Journey!

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