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Clarity + Message Strategy Intake Form
✨This form helps me understand what you’re navigating so I can support you with clarity, care, and intention. Every answer gives us a head start toward meaningful insight—before we even begin.
1. What’s your name?
*
2. What story, decision, or conversation are you replaying?
*
3. Where do you feel most unclear?
(Select all that apply)
*
3. Where do you feel most unclear? (Select all that apply)
4. What are you hoping to walk away with after our session?
*
5. Have you tried anything else to get clarity on this?
*
6. How do you usually process things?
*
6. How do you usually process things?
A
Talking out loud
B
Journaling or writing
C
Thinking internally
D
Guided prompts and structure
7. Are you open to receiving reflections or patterns I notice?
*
7. Are you open to receiving reflections or patterns I notice?
Yes
No
8. Is there anything important I should know before our session?
*
9. How did you hear about this? (Select one)
*
9. How did you hear about this? (Select one)
A
Instagram
B
Blog post
C
Referral
D
Email list
10. Your Email Address (for confirmation & Zoom link)
*
Submit
