Name
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First Name
Last Name
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1. Is there a particular area (or areas) that you would like to focus on in your Decode Your Design process? Examples include: career/job, health, environment (where you live/how you live), relationships, expression, inner and outer alignment with goals, maximizing your design.
2. What is your main growth curve at this time? i.e., In what areas do you feel directed to pay attention to and grow?
3. What do you feel your life path has been preparing you to do in this next phase? Any clues, including mental pictures and kinesthetic qualities, are welcome.
4. What qualities would you like to cultivate in our work together? (for example, clarity, groundedness, etc.)
5. Out of the following areas, please tell me which ones have the most flow and ease and those where you could be more satisfied, with 'Strongly Agree' being “most flow” and 'Strongly Disagree' being “could use some work”:
Work
Career
Finances
Friendship
Physical Health
Emotional Health
Family
Romantic Relationships
Creative Expression
Fun & Recreation
Spirituality
6. In the above areas, please tell me any significant and specific details that you think are important to clarify.
7. What do you consider to be your greatest strengths?
8. What do you consider to be your repetitive patterns/stuck spots?
9. What would others say were your 5 greatest strengths?
10. What would others say were your repetitive patterns/stuck spots?
11. Have you had an Ayurvedic pulse reading done before? If not, would you be interested in getting one done? Pulse reading is the basis for eating an Ayurvedically correct diet for your particular constitution.
12. Do you have a spiritual practice, i.e. meditation, prayer, Qi Gong? If so, what is it and how do you incorporate it into your day to day life?
13. Where have you lived? When did you live there?
14 What do you eat on a daily basis? Please give me a sense of an average day for you, including snacks and tea/coffee.
15. What would you like to see transform in your life as a result of our work together?
16. What is your birth date, time and place. Preferably off of a birth certificate.
17. Is there anything else you would like to tell me at this time for our work together?
