Personal Information
- Name:
- Date of birth:
- Marital status:
- Children & Ages:
- Email:
- Phone number:
- Address:
- Profession:
- Website:
Goals and Experience
- Have you practiced Neurogenic Tremoring before? If yes:
- How did you learn about it (e.g., workshop, online course, self-practice)?
- How often do you currently practice?
- What has been your experience so far?
- Have you encountered any challenges or difficulties in your practice that you’d like support with?
- What are you hoping to achieve or explore more deeply through our sessions?
- Are there specific areas you wish to focus on, such as physical release, emotional insight, energy flow, or something else?
If no: please learn and then practice regularly for at least three weeks before starting the process of personal sessions. A fast and reliable online method of learning is found here.
1. What are your primary goals or intentions for these sessions?
- Are you seeking physical benefits (e.g., improved energy, better sleep)?
- Emotional regulation (e.g., managing stress, cultivating calm)?
- Personal growth (e.g., connecting with intuition, clarity)?
- Stress management (one, several, or all of these)
- Other (please specify):
If yes, please describe the type(s), and your experience with these practices.
3. Are there specific outcomes you’re hoping to achieve through these practices?Health and Background
- Do you have any diagnosed medical conditions or injuries that may affect movement or physical activity? (e.g., chronic pain, past injuries, surgeries)
- Are you currently under the care of a healthcare professional? If yes, please elaborate.
- Are you currently taking any medications that might impact your physical or emotional state?
Stress and Emotional Wellbeing
- What is your current stress level on a scale of 1 to 10? (1 = very low, 10 = very high)
- Have you experienced significant stress, anxiety, or emotional challenges recently that you’d like to address during these sessions?
- Do you have any known triggers or areas of sensitivity that we should be mindful of during sessions?
- Have you experienced significant trauma or stress in the past?
Lifestyle and Habits
- What is your current level of physical activity? (e.g., sedentary, moderate exercise, very active)
- Do you have any routines or habits aimed at stress reduction or mindfulness? (e.g., meditation, yoga, journaling)
Breathwork and Integration
- Are you currently using any breathing techniques, biofeedback tools, or somatic practices (e.g., yoga, meditation)? If yes, please describe.
- Are you interested in integrating other practices, such as guided meditation, into your sessions?
Consent and Confidentiality
- Do you consent to participating in guided Neurogenic Tremoring sessions and understand that this practice is not a substitute for professional medical or psychological treatment.
- Do you agree to confidentiality regarding all personal information shared during sessions?
- Have you read and understood our Terms and Conditions?
