Healing the Patriarchal Wound Questionnaire • Dr. Melissa Sophia Joy

Welcome! We look forward to going on this journey with you. To help us plan for your time with us please answer the following questions. Thank you!

Name*
First Last
Email*
Phone*
We will be offering a tasty vegan lunches all three days and dinner on Saturday night. Do you have any food allergies that we should know about? (Note the cost for this is $65 total and you can pay this upon checking in Friday morning.)*
Do you need lodging? (FYI there is a bedroom that is available on sight, as well as overnight accommodations in the temple/teaching space. If you need lodging we will connect you to the retreat space so you can set up reservations and take care of lodging fees).*
We are planning on using high-grade essential oils as part of the intensive. Do you have any sensitivities in regard to essential oils that would prevent you from being in the room while they are being used?*
The Process
What is calling you to do this intensive right now in your life?*
What is it that you would like to get out of this intensive?*
Do you have any fears or anxieties regarding this intensive? If so, what are they?*
Do you have any trauma that you feel might influence your presence in this intensive? If so, please share what you feel is important for us to know so that we can hold this with you?*
Have you been diagnosed with any psychologically related illnesses? If so what are they? Are you on medications for this? If so, please list them here?*
Do you have any disabilities or other health concerns that could effect your participation in this intensive?*
Do you have any other concerns that we should know about?*
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The Process