Intake form | the NEST

First and Last name *

Do you have a nickname you would like to be called? *

Physical address *

Email address *

Phone / Text *

Preferred method of contact *

Email
Text
Call me

What is the best day for you to meet? *

What language do you use to describe God (Jesus, the Source, Universe, Divine) *

Briefly describe your spiritual / religious life and journey *

What, if any, are your prayer / contemplative practices? *

How would you describe your current relationship with God? *

What activities do you enjoy doing in your free time? How often do you do them? *

What are your hopes coming forth from your session? *

Type of session you are interested in *

Preliminary, first and second
Dreamwork (interpretation only)
Dreamwork within session
Weekly, monthly or quarterly (at your pace)

Are there, or have there been significant personal, professional or family issues that you would like me to know? *

Do you have (or have had) any significant health (mental or physical) issues that you would like me to know? *