Application to work with Lori

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Thank you for wanting to explore working with me one-on-one! Please help me get to know you a bit better by answering these questions before we schedule a consult. Once I review your answers, I’ll be contact with you by email.

Email *

Name *

Best phone number to reach you *

Your background

Have you worked with me before?
*

How did you learn about my work?
*

If you haven’t worked with me before, what spiritual practices are you currently engaged in?

Are your reasons for working with me personal, professional or both?

If they are professional, what is your profession?

Your Health and Wellness

Please let me know about the current state of your physical, mental, and emotional well-being.

Please list any existing health conditions/issues

Are you currently under the supervision of a doctor? If so, for what condition or concern?

Are you currently taking any medications? If so, please list.

Is there anything that may limit your engagement in our work together?

Your Intention

Please consider reading my 5 Stages of Embodied Grace before answering the following questions.

What is calling you to work with me right now?

After reading the 5 Stages of Embodied Grace, what Stage do you feel you are mostly experiencing right now? Please describe.

When considering your intention for our work together, what is it that you want the “freedom from” (ie: what are the biggest challenges you want to heal)? Try to answer in one sentence.

What do you want the “freedom to” be and/or do once you have achieved your freedom from (ie: what are your dreams and desires for yourself)?

On a scale from 0-10, how ready are you to live a GraceFilled life?

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Are you willing to invest financially in living a Grace Filled life?

Is there anything else you would like me to know before we meet?

Thanks so much for taking the time to help me get to know you better.

Here’s to healing ourselves, our children and our world.

Lori

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