Apply For Sessions — Karina Velasco

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SESSIONS AND RETREATS APPLICATION

PLEASE COMPLETE THE FOLLOWING form to apply FOR my SESSIONS and retreats

Name

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Address of Residence

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Date of Birth

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Session of Interest

Choose the session you're applying for.

What is your level of openness to uncomfortable ideas?

From 1 to 10.

Name one 30 day goal to accomplish:

Pick one issue that you are committed to solving immediately:

What is important to you in your life?

What is the primary source of pain in your life?

What is your primary source of pleasure in your life?

Why don’t yo want to stay where you are?

What do you feel has been preventing you from achieving what you want in this par of your life? What beliefs are holding you back? *

If you could snap your fingers and instantly change one thing, what would that be and why?

Are you willing and able to financially invest in yourself right now?

What do I need to know to help you move forward in your life?

Do you take any medications?

Do you have any pain in your body?

What is your stress level?

Briefly describe your life. How is life at home, relationships, parents and work.

Why do you feel you are the right fit for this session?

Session Availability

What does your schedule look like?

Referral

Name of person or media

SESSIONS AND RETREATS APPLICATION

PLEASE COMPLETE THE FOLLOWING form to apply FOR my SESSIONS and retreats

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