Name
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First Name
Last Name
Email
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Phone
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Pronouns:
What inspired you to request a personalized meditation or guided practice?
How would you describe your current relationship with meditation or mindfulness practices?
Are there specific challenges, emotions, or intentions you'd like this meditation or practice to address? (e.g., stress, anxiety, grief, grounding, joy, clarity, connection to self, or a specific life transition.)
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Do you prefer practices focused on:
Relaxation and grounding
Emotional release and healing
Connecting with your body and breath
Manifestation and intention-setting
Other (Please specify)
Would you like music or soundscapes included in the background?
Are there any mantras, affirmations, or spiritual elements you’d like included? (If yes, feel free to share specifics or leave this open for my intuitive guidance.)
Do you have any physical limitations or sensitivities I should be aware of when designing your practice?
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How would you describe your current emotional landscape? (e.g., calm, overwhelmed, restless, grieving, hopeful, etc.)
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Do you follow any spiritual, cultural, or religious practices that you’d like me to incorporate or honor?
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Is there a specific intention, word, or phrase you'd like to anchor this practice around?
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If this meditation could help you feel one way, what would that feeling be? (e.g., peaceful, empowered, safe, connected.)
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Is there anything you’d like me to avoid in your meditation or practice? (e.g., certain language, themes, or tones.)
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Would you like me to send you a draft or key themes for your approval before recording?
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Is there anything else you'd like me to know to create the most supportive practice for you?
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