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the authentic shift coaching intake form
hi friend.

thank you for taking a few minutes to check in with yourself and share what brought you here. 

this is intended to ensure now is a supportive time for you to lean into this work.

this  three or six month bi-weekly container weaves breathwork, somatic coaching, and intentional practices to help you reconnect with your body, deepen your care practices, and build an empowered relationship with your Self. we’ll explore the mind-body-spirit connection & emotional agility, shadow & inner child work, rest & creativity and boundaries, purpose, and your role in collective care. the experience includes session recordings, journal prompts, and integration tools when relevant. 

financial exchange
3mo $1500 / 6mo $3000

if you are interested in only building a breathwork practice, you can find breathwork packages that include breathwork sessions only here. feel free to still fill out this form if you'd like to share this info prior to your packages. 

if you end up with more questions filling this out, feel free to reach out or grab time with shannon here. 

take care & talk soon. 
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Email *
name please *
pronouns that make you feel like you 
what is motivating you to sign up for breathwork coaching? *
how familiar are you with mind body spirit practices (mindfulness, meditation, breathwork, journaling)?  *
not at all
i've tried it!
regular part of my practice
love it - a go to for support
breathwork
meditation
journaling
mental health movement
therapy
creative expression
community support groups
which of the above are you most interested in exploring? you can list a few! (FYI i do not offer therapy but can make local recommendations) *
what are you hoping to walk away from this experience with?  *
PLEASE a top priority
this would be amazing too
less of a challenge but here for the support
chill my inner critic & be my own biggest hype human
strengthen confidence in my mind body & spirit
clarity in what to do in my life
heal & integrate past experiences
get through the days with more ease
build an authentic Self care practice
slow down and live with more presence
how would you like to feel at the end of this experience? what changes - internal or external - would you like to experience? 
what challenges do you anticipate in any and all of the above?  *
how do you currently support your mind?  *
Required
how do you currently support your body?  *
Required
how do you currently support your spirit?  *
Required
anything else that you'd like to share to help make this a supportive and expansive space for you?  *
self healing breathwork is powerful - it can build self awareness in the mind, processes stuck energy in the body and connects you with your inner wisdom. sometimes that looks like integrating your childhood and the tough stuff that hurt - in a beautiful and sometimes intense way. you'll have the support of shannon in integration and also you are responsible for your own healing outside of the container. thumbs up that you have a solid support system (i.e. therapist, supportive community) for processing outside of this space.  *
the deeper style of breathwork we will be utilizing is not recommended for pregnant folks or individuals with cardiac concerns, glaucoma, history of psychosis or schizophrenia, and/or panic disorder. if you fall in any of these categories or have any sort of health concern, give a thumbs up that you'll confirm with your healthcare practitioner for clearance or reach out to shannon with questions. 
 *
this experience is an investment. financially, energetically, emotionally, mentally & spiritually. thumbs up that you're ready to commit to being present for this work for the length of your container. if not, that's okay too. no wrong answers. if you're not sure, head to the top for the link to book time with shannon to explore options. you can still fill out this form if you want too. 
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