Welcome to your
RISE UP RETREAT!

During our time together, we’ll choose a strategy personalized to get you where you want to go, build a doable action plan to take you there, and set you up with powerful tools you can use to implement that plan despite the inevitable obstacles.

To get started, please complete this form to the best of your ability. Your transformation will begin simply by doing the self-exploration necessary to answer these questions.

There are no wrong answers, and you will NOT be judged, so please feel free to share candidly as you would with a counselor or therapist (although, legal disclaimer: I am NOT a licensed or registered counselor, therapist, or other health practitioner).

In addition, please trust that I will maintain every detail you share in the strictest confidence and with the highest respect for you and your beautiful soul.

Some of these questions may seem unusual, but they are carefully designed to help me understand your FULL situation prior to our meeting. This allows me to make the most of our time together.

I'm looking forward to receiving your answers and talking with you soon!

Name *
Name
Phone
Phone
http://
This could include goals you would like to achieve, but should also include how you'd like to feel and what you would like your lifestyle to look like.
Please take a moment to search your mind for the specific thoughts that come up such as, "It seems like it's out of my control," "I don't have enough time," "I procrastinate too much," "I don't know where to get started," etc.
What are the nature and quality of your very first thoughts of the day? Do you usually begin running through a list of everything you have to do? Do you start worrying about everything that needs to be done? Or do you just jump out of bed and head straight to the shower or the coffee maker?
Does it include daily prayer, meditation, study, contemplation, or some other activity? How often during the day do you “check in” with your spiritual nature? Do you attend services or other groups (in person or online)?
Do you call your friends, make a list of pros and cons, sit and think hard about your choices, pray about things, meditate, avoid and procrastinate — or some combination of these things? Or something else entirely?
Let’s say the car breaks down, or you or someone you love gets ill. Or you receive an unexpected bill, or an email delivering “bad news.” What do you usually do, emotionally? (get anxious, cry, get angry, etc.) What do you do, physically? (call someone, go for a run, beat a pillow, etc.)
Please try to recall at least three, if you can.
List any and everything. Family members, pets, your computer, your car, home, needing to be warm, needing to be cool, needing to have peace and quiet, needing to live in a certain part of the country or the world. List that comes to mind.
Do you see it as a generally friendly, helpful place? Or do you see that people lie, cheat, steal, and otherwise seem to hurt each other? Do people do rude things in traffic or the supermarket? Or do they mostly seem to be kind and polite? When you or someone is in need, does it seem like there is always assistance?
If that second question seems confusing to you, imagine that the world is only a tool or device for your use. What do you think you are using it for? Allow yourself to write whatever comes up first when you consider this question.