Consultant Intake Form

A copy of your submission will be sent by return mail for your reference.
After reviewing your submission, we will be in touch. Thank you!

  • Include college degrees, certifications, professional courses, and dates received for each.
  • Have you conducted/participated in any holistic practices? e.g. Rieki, re-birthing, etc. used an naturopath/herbalist? If so, which practice(s) and for what length of time? What was the result of your participation?
  • For what reason(s) do you want to help people with their life situations/problems?
  • If you have been helping people with their life situations/problems – for how long? And in what capacity?
  • Share more about yourself. What makes you who you are?
  • Have you experienced an adverse or traumatic situation/event in your life? If so, share highlights. What type of therapy/healing have you used to process the situation/event?
  • How you do you intend to integrate the MyE.M. process into to your current practice?
  • Are you willing to commit to the learning experience of MyE.M. for 6 months? Classes will take place once every two weeks.
  • Thank you .

    Beverley Searle
    Beverley@myenvisionedmind.com

  • This field is for validation purposes and should be left unchanged.

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