Form cover
Page 1 of 1

🌙 SOMATIC EMOTIONAL CLARITY SURVEY

Somatic Emotional Clarity Survey
A 5-minute journey into your emotions, inner wisdom, and somatic truth.

Thank you for contributing to this research for awakening women who feel overwhelmed by emotions they’ve never been taught to hold.

My work supports women in dissolving emotional chaos, releasing stored emotions safely, and reconnecting with the version of themselves they sense but can't quite reach — using my signature somatic method:

The Phoenix Rebirth Method™ Descent → Release → Rebirth

Your answers help me understand the emotional, energetic, and life experiences women are navigating — so I can create healing spaces, tools, and programs that meet you exactly where you are.

As a thank you, you’ll receive a FREE Somatic Clarity Session (valued at $297) — a pure emotional + energetic coaching session. This is NOT a sales call — just support, safety, and clarity.

Limited to the first 7 women who complete the survey.

Let’s begin, beautiful. 👇


✨ SECTION 1 — About You

What is your name

What is the best email to send your session link to?

Drop your social media link (Instagram, Facebook, or LinkedIn)

What stage of your personal or spiritual journey do you feel you're in right now?

What stage of your personal or spiritual journey do you feel you're in right now?
A
B
C
D
E
F

✨ SECTION 2 — Emotional Patterns

What emotions feel the hardest for you to sit with right now?

When stress and overwhelm hits, what do you typically do first? Avoid? Shutdown? Push through? Overthink?

Is there a repeating emotional pattern or cycle that you feel stuck in?

✨ SECTION 3 — Somatic Awareness

What sensations show up in your body when you feel overwhelmed? (e.g., tight chest, lump in throat, racing heart)

Do you feel like you understand your emotional triggers? Why or why not?

If your body could speak clearly to you in this moment, what do you sense it would say?

What kind of support do you feel you need most right now? (Emotional, somatic, clarity, guidance, accountability?)

✨ SECTION 4 — Support & Next Steps

Would you like support to move through these patterns with a free Somatic Clarity Session?

Would you like support to move through these patterns with a free Somatic Clarity Session?
A
B
C

If yes or maybe, what's the best day(s) for you?

Thank you for being here. Your honesty and willingness already show how deeply you’re ready for change. Your session details will be sent to your inbox if you opted in.

I’ll carefully review your answers and, if you opted in for a session, I’ll send your session details and next steps directly to your inbox.

You’re doing beautifully. 🌙💛