The Evolved Woman Nervous System Elixir ProgramINTAKE FORM Name * First Name Last Name Email * Phone * (###) ### #### What motivated you to join The Evolved Woman Program? * Describe your current personal and professional situation. * Which specific areas in your life are you looking to transform or expand on through this program? * Have you previously participated in personal development programs? If yes, share your experiences. * On a scale of 1-10 how committed are you to your expansion, body, mind and spirit? * If you could overcome one specific challenge through this program, what would it be? * What would it mean to you to find a deeper sense of trust and of safety within your body and nervous system and in connection with supportive women? * Are you committed to fully engage in the program and embrace the teachings and practices? * What is first step you are taking towards your unique transformation? * What changes do you hope to see in your life in the 10 week journey of The Evolved Woman Program? * How important is it to your to improve you skills in setting boundaries without feeling guilty? * Which areas of your life feel most important for you to evolve i9n this season? Do you have any specific dietary requirements for our half day retreat? * Do you currently experience symptoms of PTSD, C-PTSD, anxiety, depression or other mental health concerns? If so, please share. * Do you have any medical conditions or are you taking any regular prescription medication that you feel is relevant to the program? If so, please share. * Are you ready to prioritise you and connect with your unique feminine essence so you can pour from a full cup?! * Do you have any questions regarding the program or is there anything more you'd like to share about yourself? * Thank you for taking the time to share your responses. We look forward to connecting with you soon regarding your application xo
