Lesson 7 – FORM – Initial Client Intake Form

Intake Form

How did you hear about Transcendence?

What inspired you to reach out to us?

Where are you on your Journey? (What books have they read, and what spiritual teachers do they follow? This will help you determine where they are in terms of their spiritual awareness.

What is your intention for the session? Allow them to talk a bit here and see if you can find their level of awareness and responsibility.(Find out what they want that they do not have)

-If they want intuition or spiritual abilities, they lack only self-trust.

-If they want money – they have safety issues, self-value and freedom issues.

-If they want more time – They believe they cannot achieve their desires.

-If they are having relationship issues, its about not having self-love.

-If they are having health issues, his is about denying themselves of their higher presence and source energy, as well as having issues with self-hate, judgment and a fear of the world.

Do you feel blocked, confused or stuck in your life in some way? Referto the following areas of their life:

-Time management –do they have enough time?

-Relationships –Are they happy?

-Health-Do they have any health issues?

-Money-Do they have a lot, just enough or are they in lack?

What medications supplements are you taking? Look into big book to find emotional pattern linked to body system

What is your diet? This will help you determine where their vibration is: high vibe /low vibe

How do you sleep?

What does your wealth, your work life and you purpose look like? Are you living a double life?

What was the last book you read/class you attended/teacher you follow? This will help you speak their language.

Do you have trouble manifesting what you want?

Do you have difficulty being heard or seen by peers, family or business associates? Are you able to be authentic?

Do you worry about or have fear surrounding your health?

What pattern in your life has been chronic? Are they repeating relationship drama, health issues, accidents….what are they recycling in their story?

How safe do you feel in your life?

What helps you feel safe?

What makes you feel trapped?

What are your pet peeves? This will highlight their chronic mirror and their self-judgment


Condition of body:

Note skin coloration, whites of eyes, red patches, hair loss or gain, body odor, body size, are they making eye contact? Are they talking over you? Are they listening?

Listen to their language:

-Notice if they make observations in the negative-Are they a victim? Do they have a lack mentality? Do they have patterns of negative self-talk?

-Do they say things like “I can’t”, “I don’t have time” or “I am not supported”?

-Notice if they use contradiction words like “but”, “don’t have” or “can’t”.

-Notice if they talk in the past or in the future tense.

Listen to their needs and wants:

-Do they say things like, “I am ready”, “I am tired of this” or “I am willing”? If yes, then they are ready for you.

-Feel what your intuition says (FIRST 3 seconds) about what they want and need. Feel if they are ready for the work.


What wounds did you notice? (Refer to wounds list)

-I am not heard

-I am not seen

-I am not loved

-I am not safe

Where is their block or where are their blocks manifesting?





Where do they not feel safe?

Where can they not be authentic?

What/who is toxic to their healing?

What is their story?

Look for the re-occurring patterns in health, in their relationships, issues with co-workers, with their money or being constantly hurt for being authentic.

Part 2 – Setting up a package for treatment and pricing

Intake form 6.9.16-2