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Deep Integration 1:1

Before entering a Deep Integration container, I'd like to understand a little more about where you are and what brings you here.

This is not an assessment and there are no right answers. The purpose is to ensure the work is appropriate, safe, and aligned for both of us.

Deep Integration is generally most effective in person. Virtual containers may be available in certain circumstances.

First Name

*

Last Name

*

Email address

*

Current City / Location

*

Have you already completed a System Reading with The Liminal Quest?

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Have you already completed a System Reading with The Liminal Quest?

A

Yes

B

No

What draws you toward deeper work at this time?

*

What feels most difficult to move beyond on your own?

*

What patterns, situations, or experiences seem to repeat despite your awareness of them?

*

Have you previously worked with any of the following?

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Have you previously worked with any of the following?

Therapy

Coaching

□ Somatic work

□ Breathwork

□ Meditation

□ Plant medicine

□ Retreats

None of the above

□ Other

What has been most helpful so far?

*

How would you describe your current emotional and psychological wellbeing?

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Have you ever been diagnosed with, treated for, or experienced any of the following?

*

Have you ever been diagnosed with, treated for, or experienced any of the following?

Psychosis

□ Schizophrenia

□ Bipolar Disorder

□ Severe Depression

□ Dissociative Disorder

□ PTSD

□ None of the above

□ Prefer not to say

Are you currently under the care of a psychiatrist, psychologist, therapist, or mental health professional?

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Are you currently under the care of a psychiatrist, psychologist, therapist, or mental health professional?

A

Yes

B

No

C

Prefer not to say

Have you experienced any of the following during the last 12 months?

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Have you experienced any of the following during the last 12 months?

Panic attacks

□ Severe depression

□ Suicidal thoughts

□ Psychiatric hospitalisation

□ Psychotic episodes

□ None of the above

□ Prefer not to say

Is there anything regarding your physical or mental health that would be important for me to know?

*

Which format are you interested in?

*

Which format are you interested in?

A

In-person (preferred)

B

Virtual

C

Open to either

If interested in an in-person container, would you be willing to travel?

*

If interested in an in-person container, would you be willing to travel?

A

Yes

B

No

C

Depends on location

If yes, what regions or countries would you realistically travel to?

*

What would make this container meaningful for you?

*

Is there anything else you would like me to know?

*

Consent

*

Consent

I understand that this work is not psychotherapy, medical treatment, crisis support, or a substitute for professional mental health care.

Disclaimer

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Disclaimer

I understand that submission of this form does not guarantee acceptance into a Deep Integration container.