Name
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First Name
Last Name
Email
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Place of Residence
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Occupation
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What main limitations, obstacles, or edges are you currently experiencing in your life and/or relationships?
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What three shifts are you most wanting to create in your life and/or relationships as a result of your work with Nina? How do you envision yourself in one year from now?
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Please list any trainings, programs, or courses you have attended in the realms of personal growth, spirituality, and/or sacred intimacy.
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Do you have a regular spiritual practice such as meditation, prayer, yoga, etc.? If yes, please describe.
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Have you in the past two years been under the care of a therapist or mental health professional? Have you ever experienced any traumatic or emotional conditions that are relevant to this program, including childhood emotional or physical abuse? If yes, please describe.
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How did you learn about Nina?
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Is there anything else that may be important to know about you?
