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Talisman Intake Form

Please answer the following 13 questions fully. Accurate and honest information is foundational to a successful restoration. I appreciate your candor and so look forward to working with you in this way. 🌻

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Question 1 of 15

1. Even though this process will focus on what your soul prioritizes rather than what you *think* you want, I’d love to hear if there’s anything specific you would hope for. If there was one thing you could ask for and receive out of this process, what would it be? 

Question 2 of 15

2. This process can absolutely be completed despite chronic health issues, but if there is acute illness or flare it’s best to wait. Do you have any physical illnesses significantly impacting you at this time?

Question 3 of 15

3. At this point I am not experienced enough to do this process for those with significant and acute mental health challenges. That said, there is still a significant range that is totally workable. Do you have any mental health challenges or a history of trauma that impacts you? Please be super clear about this section so I can get my teacher's full support.

Question 4 of 15

4. While remarkably gentle, this work can bring up emotions and catalyze changes.  Anticipating that, how strong is your support network these days including partners /friends /family /community as well as therapists /practitioners /elders or other places you experience support and solace? Feel free to share a bit just so I know who is also supporting you as this work supports you!

Question 5 of 15

5. Talismans are made with various substances which can come in contact with your skin. They may include coconut, honey/beeswax, nuts like almond, cornmeal, and other stones and plants. Are you allergic to contact with anything I've listed or anything known otherwise? You will not be asked to ingest any substance.

Question 6 of 15

6a. Do you have a challenging relationship with alcohol? If so, I will simply use alternatives!

Question 7 of 15

6b. There is a (possible) specific ritual with your ancestral line. If this is required, would you say alcohol is fine for everyone or is there a history of alcoholism and it would be better if I used an alternative? (Note, if you have a challenging relationship with Alcohol I will use substitutes regardless of your ancestral line)

Question 8 of 15

7. Some ingredients have a naturally stronger scent, and certain pre and post restoration work includes incense for fumigation. Do you have significant sensitivities including scent and/or are you unable to work with smoke?

Question 9 of 15

8. Your process may include pouring liquid over your head, short soaking baths or anointing yourself in spots from your head to toe. We can absolutely make modifications as needed. Do you have any physical limitations or range of motion issues that you already anticipate will necessitate modification?

Question 10 of 15

9. Do you have access to a bathtub if a soaking bath is required?

Question 11 of 15

10. I may ask you to tie string around a wrist, wear something around your neck, or carry a talisman in your pocket/on your person. Is there anything about your personal or professional life that might mean you can’t wear or carry things on your wrists/neck/pocket?

Question 12 of 15

11a. I'll be speaking your name and referring to you during the soul restoration process. What is the name (either first name or full name) that you would like to be called?

Question 13 of 15

11b. What are the pronouns you would like me to use? 

Question 14 of 15

12. As part of the process, I will make brief contact at the level of soul. This isn't like visiting a psychic and I won't be seeing your history or affecting you in any way. It’s more like a simple “hello at spirit” and a way to anchor the work. Please take a moment to close your eyes and affirm permission. Do you consent to soul contact?

A

Yes, I consent to Soul Contact

Question 15 of 15

13. What is the full name and mailing address for sending the Talisman? (And if there is a mail service that is necessary or preferred for your area, please let me know.) If you are international, please also provide a phone number for the customs form.

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