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Empowered with Alana

Spiritual Counseling & Coaching Services

WelcomeHomepage
About MeEducation & Skills
My OfferingsGuidance & Services
Free ResourcesArticles, Worksheets, etc.
ConnectSee if We Vibe
ShopMystic Merch

WelcomeHomepage
About MeEducation & Skills
My OfferingsGuidance & Services
Free ResourcesArticles, Worksheets, etc.
ConnectSee if We Vibe
ShopMystic Merch

New Client Intake Form

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New Client Intake Form

New Client Intake Form

This must be completed before our 1st coaching session.

Coaching Intake Form

Personal Information

Just the basics...

First Name

Last Name

Preferred Name

Email

Phone/Mobile

Full Address

Address Line 1

Address Line 2

City

State/Province

Zip Code

Country

Date of Birth

Time of Birth (if known)

Location of Birth (if known)

Personal Learning Preferences

These questions are aimed at exploring the ways you learn best to help you grow and evolve along our journey together.

How easy is it for you to meditate?

Usually it's very easy

Sometimes it's easy, sometimes not

Usually it's hard

I can't meditate at all

How easy is it for you to visualize images in your mind?

So easy, I get lost in daydreams

Sometimes it's easy

Not very easy at all

I find it hard to visualize anything

Do guided meditations contribute positively to your personal reflection and relaxation practices?

How effective do you find reflective exercises, such as journaling or worksheets, in facilitating your personal growth and learning?

Do you find that engaging in creative activities (e.g., drawing, painting, making music) aids in your spiritual or self-exploration process?

Are you interested in exploring insights from sacred texts and spiritual philosophies as part of your growth journey? If so, are there any particular cultures, religions, philosophies, traditions, or texts you are drawn to?

Which personal development tools or methodologies have you found most effective or appealing in your journey thus far (e.g., cognitive-behavioral techniques, mindfulness, affirmations)?

Diving a Bit Deeper

This section helps me understand your current mental, emotional, physical, and spiritual state.

On a scale from 1 to 10, how comfortable are you with exploring emotional aspects and vulnerabilities as part of your growth process?

1

On a scale of 1 to 10, how open are you to trying new spiritual practices or personal growth techniques that may be unfamiliar to you?

1

Do you know what 'shadow working' is?

I have no idea

Yes!

Have you worked with your shadow before?

I'm not really sure

Yes, many times

No, I have not explored my shadow

Does shadow work scare you?

Not at all!

Sometimes it can be scary

I'm too afraid to explore my shadow

Looking ahead, what are your long-term goals for personal and spiritual development? How do you envision your journey evolving over time?

What are your major objectives or desired outcomes that you wish to achieve from your coaching sessions with me?

How do you want to FEEL at the end of your coaching experience with me? (focused, accomplished, liberated, happy, etc.)

Final Questions

These last few questions will help me to hone in on where and how I can best serve you along this journey.

What do you want to gain from your coaching sessions? Select ALL that apply.

feel gratitude for what I have

feel happiness & joy

be a better friend

learn how to love myself

learn how to forgive

silence my harsh inner critics

stop feeling anxious and/or depressed

heal my Mother/Father wound

gain new insight into who I am (strength, capabilities, & potential)

stop drinking, smoking, or using other substances to cope

gain knowledge about the science of trauma

reduce or stop nightmares

find new ways to be happy

reduce or stop panic attacks

feel worthy of success

feel worthy of abundance

stop lashing out in anger at my loved ones

be a better parent

learn healthy coping mechanisms

stop negative, intrusive thoughts

stop feeling guilty

eliminate obsessive thoughts and compulsive behaviors

stop being closed off emotionally

be a better romantic partner

feel purpose about my life

gain clarity of my trauma

understand my triggers

feel worthy of happiness

stop feeling ashamed

heal my inner child

become a more loving person

regulate my emotions better

discover more about myself

overcome feelings of fear

feel liberated from my past trauma

What else should I know about you before we begin together?

“Alana has helped me to live my truth! She taught me how powerful I can be to just observe my feelings and fully feel them, but not let them change how I feel about myself. She has taught me to face fear and not let it dictate my decisions and to reflect inward about why that fear is present.” – Tammy M.

This website and its content is for general informational purposes only and does not constitute personal medical or mental health advice. Viewing the information on this website is not intended to create and does not constitute a therapist relationship. Readers should seek individual professional medical/mental health advice before acting on any information contained in this website. The information on this website should not be considered complete and should not be used in place of a visit, call, consultation or advice of your health care provider or mental healthcare provider.

Free Resources

Healing the Mother Wound
January 8, 2023
FREE Resource: Radical Acceptance
April 19, 2024
The Labyrinth of the Soul
September 18, 2023
Understanding Your Trauma Responses
September 25, 2022

Happy Clients

Alana has a gift of insight and intuition that is beyond this realm. Her many years of training, education, and personal experience traversing the insane shadows of her own life has resulted in her unshakeable dedication to Love and Truth. Her profound ability to acutely and clearly perceive the shadow with non-judgment, helps anyone to cut through and powerfully transmute their own darkness back into Love. Alana is a gift to this planet.

Sarah B

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