Welcome to the Sovereign Sisters Rising Experience, Sister!

Please fill out the intake questionnaire below to the best of your ability. Try to give yourself some quiet time and spaciousness to complete it, away from any external distractions. These are just some preliminary questions that we can keep on record for our journey together. You'll be receiving the Sovereign Sisters Rising workbook at our first sisterhood gathering. We can't wait to get started! And if you have an questions at all, please reach out to me at LainieLoveDalby@gmail.com.

Name

First Name

Last Name

Email Address

Cell phone

(###)

###

####

How did you hear about the Sovereign Sisters Rising Experience?

What called you to sign up for the Sovereign Sisters Rising Experience?

What do you feel is at the heartbeat of being a woman right now in our world?

Do you currently have a relationship with the fierce feminine? If yes, please describe!

Have you participated in an in depth personal or spiritual development program in the past? If so with whom and what was the structure? How was the experience for you?

What is your religious/spiritual background?

What do you hope your life will be like after this 7 month program?

What is your intention for our 7 month journey? (this can change & shift over time)

How would you assess your ability to get along with other women in groups?

When big emotions come up for you, how do you take care of yourself?

Do you have complex trauma in your history?

Do you currently take any medications or have any medical conditions we need to know about? If yes, please list them and what they are being used to treat.

Are you presently diagnosed or being treated for depression? Have you been diagnosed with any mental illnesses that would make SSR challenging or induce trauma?

Do you receive any forms of healing or body work? If yes, what types and how often?

Do you have a regular therapist or mental health practitioner that you see? If yes, how often?

Please list any specific dietary restrictions or allergies (food, environmental, etc)

What are you 3 favorite songs to listen to/move to right now?

Emergency Contact

First Name

Last Name

Emergency Phone Number

(###)

###

####

Is there anything else you'd like me to know before we begin this 7 month journey together?

Welcome to the Sovereign Sisters Rising Experience, Sister!

Please agree to the Terms & Conditions and sign the Liability Waiver Below