I was inspired to start this process because…
The top 3 things I want to improve about my life are...
What does the word JOY mean to me?
The top 10 words I would use to describe myself to a stranger are…
The people closest to me love being in my life because...
What physical symptoms / ailments / imbalances do I currently experience or have experienced in the past 6 months? How have these impacted my life?
When I am in physical pain, what helps me feel better?
What mental and/or emotional symptoms / ailments / imbalances do I currently experience or have experienced in the past 6 months? How have these impacted my life?
What aspects of my life and health are working really well right now?
When I am in emotional pain, what helps me feel better?
Do I currently work with a therapist, coach, mentor, or other mental, emotional, or spiritual health professional? If so, what form(s) of therapy / healing / guidance are used?
Am I currently taking any prescribed medications? If so, how do they make me feel? (Please provide the name, dosage, frequency, duration, and reason for taking.)
Am I currently taking any supplements or herbs? If yes, how do they make me feel? (Please provide the name, dosage, frequency, duration, and reason for taking.)
Do I have any known allergies or sensitivities? If yes, to what, and what is the reaction?
What physical or psychological diagnoses have I received from medical or mental health professionals throughout my life? Also, at what age did I receive each one, what symptoms or life events was I experiencing at the time, and how did each diagnosis make me feel?
What approaches, therapies, medications, supplements, etc. haven't worked for me, and did I have any adverse physical or emotional reactions? My 3 most prominent exp
My 3 most prominent experiences from childhood that have had a lasting impact on me, whether positive or negative, are...
What do I regret the most in life?
What was the happiest time in my life? What was happening, where was I, who was I spending time with, and how long did it last?
How do I feel about entheogens? (psychedelics / frog and plant medicines including Psilocybin, Ayahuasca, San Pedro, Peyote, DMT, Bufo, Kambo, Iboga, Ibogaine, etc.)
What has my experience been with entheogens, if any? (Please provide the medicine, number of times received, date last received, the setting - whether with a guide in ceremony or for recreational purposes, and details about your experience.)
Regarding my relationship with alcohol: Is it a part of my life? If so, what is my drink of choice, how much do I drink at one time, how often, why, and do I feel in control?
Regarding my relationship with tobacco, electronic cigarettes / vaping, and marijuana: Are any of these actively a part of my life? If so, how often do I use them, why, and do I feel in control?
Regarding other recreational substances / drugs: Are any of these actively a part of my life, how often do I use them, why, and do I feel in control?
(If I am radically honest with myself...)
What unhelpful thought patterns or behaviors do I have that I want to break?
What frustrates me about myself?
What makes me really angry?
What am I addicted to? (behaviors, people, substances, activities, emotional states, etc.)
What am I afraid of?
What is my relationship to Spirit / Source / Universe / God?
If I was a genre of music, which one would I be?
What is the last book I read?
What topics / subjects fascinate me the most?
What hobbies / interests am I most passionate about?
What is my spirit animal?
What do I need from the team at Ocho to feel safe in my healing process?
Submit
Thanks for completing your Intake!
