Soul Witnessing Intake Form

Preferred Name (First)

Last name

Pronouns

Email

Date of Birth (You MUST be 18 or older)

Día

Mes

Año

What’s pulling you toward Soul Witnessing right now? Is there something you’ve been carrying alone that you hope to lay down?

Final Note:

You don’t need perfect answers. You don’t even need to be sure. Just answer honestly. I’ll meet you there.

I certify that everything listed on this form is true. I understand that Soul Witnessing does NOT involve mental health therapy or crisis support.

I understand that each session is $1,111.11. If approved, I will be required to pay for the Witnessing session at the time I schedule it.