Transformative Wellness Onboarding

Psychedelic Coaching Onboarding

Please complete this questionnaire as honestly as you can. This is your first step into a journey of transformation ahead of you, it will be a point of reflection once the program is over and a guiding piece during it.

This is your crossing-the-threshold moment.

In the Hero's Journey, it's the point of no return, the moment when the hero DECIDES to leave behind the familiar in order to answer the call to adventure. It is the step into the unknown, trading safety and comfort for the chance to bring forth what is within them. 🌱

Email *

Full Name *

Date of Birth *

Part 2: Psychological & Emotional Landscape

1. Have you experienced any traumatic events? * E.g., could include but are not limited to:

Early childhood neglect or abandonment Loss of a parent through divorce, abandonment, death, or other reason Lived with anyone who was depressed, mentally ill, or attempted suicide, had a problem with drinking or using drugs Lived with anyone who went to jail or prison Were physically (violently or sexually) abused, or lived with an adult that insult you, and significantly put you down Been involved in a car accident, natural disaster, traumatic sports injury None Other

2. If you answered yes to the question above, what steps or actions have you taken to address or cope with the trauma? How much would you say they are still impacting you today? *

3. What do you want to achieve with psychedelics? Why is it important to you? * How would achieving your goals shift your life, your sense of self and the experiences you create for your life?

4. What could get in the way of you accomplishing these goals or making the most of our sessions? * Have you already tried to shift this? What worked, what didn't?

5. What would help you feel supported when your nervous system feels overwhelmed? * (Loss of breath, feeling anxious or even scared) What helps you come back to your center? How can I be an effective ally in those moments?

6. How would you describe your mood on a typical week? *

7. What are your current stressors? *

8. What gives you hope or a sense of possibility in life right now? *

Part 3: Social Context & Support

1. Please briefly describe your current life situation. *

2. Do you have any prior experience with therapy or coaching? * If so, how was it? What did you gain from it, and what did not work for you?

3. How do you prefer to receive feedback? * Are there any communication preferences or needs I should be aware of to support you best?

4. What are the most meaningful relationships in your life right now? *

5. Do you feel supported by your social environment? In what ways? *

6. Are there any cultural or identity aspects that are important for me to understand in supporting you? *

Part 4: Spiritual Exploration & Meaning

1. What, if any, spiritual practices do you have currently? * Yoga, Meditation, prayer, and church community, etc.

2. Please briefly share your experience with contemplative practices * e.g., meditation, breathwork, yoga, float tanks, sound healing, journaling, etc., as well as prior personal development work. What have these practices done for you or to you?

3. What do you hope to achieve from our work together? What called you to this container? Why now? *

4. Please describe any previous psychedelic experiences including microdosing and anything that you would like me to know with regards to psychedelics. * E.g., bad experiences, adverse side-effects

5. Do you consider yourself spiritual in any way? If so, what does that mean to you in your own words? *

6. Are there things (big or small) that give your life a sense of meaning, connection, or direction right now? * If not, that's okay too.

7. Have you ever experienced a sense of awe or deep connection with something bigger than yourself? * Whether in nature, with others or in stillness?

8. What words would you write to yourself that you have always wanted to hear someone say to you? *

Is there anything else you'd like me to know about you?

I agree to have my information stored securely on a private server to be contacted about facilitation services.

Thank You

Thank you for taking the time to fill this out and for the trust to share a deep part of yourself with me. I look forward to walking this journey with you.

🪷

BeLiveAble Transformative Wellness