SACRED WILD HEALING—PRIVATE MENTORSHIP APPLICATION
Thanks for applying for the Sacred WIld Private Mentorship program! Please respond freely whatever comes to mind in response, and know that everything you share is held in strict confidence. There are no "wrong" answers!

Notice also the clarity that comes from just answering these few simple questions and signaling your intent! You will receive a personal response from me via email if I feel that we are a good match at this time, or if not.

Love,
Satya

Email address *
Full Name *
Your answer
1. What gives you the feeling of really coming alive—a boundless joy in your heart more than anything? *
Your answer
2. Where could you use some real clarity and support in your life right now? *
Your answer
3. What do you hope to achieve in our three months mentorship together? *
Your answer
4. What excites you most about attaining that? *
Your answer
5. Where or how do you you feel blocked from that now? *
Your answer
6. Are you willing to go all in and show up every day - FOR YOURSELF - to make it happen? (I will guide you steadily, but it's on you to do the work) *
Your answer
7. Do you have any experience with breathwork, meditation, or energy healing that you can share with me?
Your answer
8. What payment terms are you interested in? *
9. Do you agree to the terms of the Medical/Liability Disclaimer below? *
I understand that Satya Colombo is not a licensed healthcare provider, and that Breathwork, Energy Healing, Spiritual Counsel and Mentorship are not a substitute for medical or psychological treatment from licensed and registered healthcare professionals. I agree to not rely on the information I receive from Satya Colombo, his staff, or any other participants in the Sacred Wild Healing — Private Mentorship Program as an alternative to medical advice from my doctor or other professional healthcare provider. I hereby release Satya Colombo and his staff, agencies, heirs or assigns, from all liability and responsibility for any actions or results or adverse situations created as a result of any advice, information or assistance I receive from Satya Colombo, his staff, agencies or assigns, or any other participants in the Sacred Wild Healing — Private Mentorship Program.
Your answer
10. Questions, thoughts, or anything else I should know? *
Your answer
11. Your Mobile Phone *
Your answer
12. Your Mailing Address *
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service