Bio-Mystical Womb Case Study Research Application and Agreement
Thank you for applying to be included as a case study in my Bio-Mystical Womb book. Please answer the questions as thoroughly as possible, as this will influence my decision about who to work with. I want to see how forthcoming and descriptive you can be about your Womb Wellness as well as how much time and dedication you are willing to put into the project. I plan on giving a lot of support and care to my Case Study subjects and I want to see that you will give similarly.
Email address *
What is your name and where do you live?
Your answer
What pseudonym would you like to go by if chose to be a case study subject for the project?
Your answer
What does the term "Bio-Mystical Womb" mean to you?
Your answer
Please describe any mystical experiences you have had that you feel are associated with your womb.
Your answer
Please describe any healing processes you have gone through around your womb and any mystical/emotional components involved in that process.
Your answer
Please describe your spirituality in relation to the feminine aspects of spirit/divinity.
Your answer
Please describe any mystical experiences you have had around sexuality, fertility, menstruation, pregnancy, birth, and/or menopause.
Your answer
Please describe any ceremonial/ritual practices you engage in around your womb.
Your answer
Please describe any mystical experiences you have had with your ancestors/past lives/spirit babies/future descendants.
Your answer
Please describe any extra-sensory abilities you have (ie: mediumship, psychic abilities, clairvoyance/audience/sentience, empathy, etc) and how you feel these are related to your womb.
Your answer
Statements of agreement: Do you agree to participate in actively receiving and engaging with Sama Morningstar's Womb Wellness services, completing a thorough description of your experiences before, during, and/or after each session/course component, and submitting these descriptions to Sama in a timely manner?
Do you agree to permit Sama Morningstar (legal name Jessica Huckabay) to use any writings you share with her about your Bio-Mystical Womb experiences in her upcoming book using the pseudonym you provided earlier in this form to protect your anonymity? And to take responsibility for changing the names and identifying details about the people and circumstances in any stories you share as necessary to protect the anonymity of those involved?
Do you agree to forego any compensation for the use of what you write in Sama's book besides receiving free/extra/and/or discounted Womb Wellness Services during the process per your individualized agreement with Sama and a copy of the book once published?
Would you be willing to volunteer to assist in proofreading the book?
Would you be willing to participate in podcast interviews about your participation as a case study in the book? (You would not be anonymous in these interviews, but would not be required to share anything you weren't comfortable with sharing publicly, nor would you be asked to share the pseudonym you used in the book.)
Please describe any other way you feel inspired to contribute to this project.
Your answer
Do you have any questions about the project? If so, please list them here.
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy