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First Name

Last Name

Married Name

Preferred Name

Date of Birth

Current Country of Residence

Current Occupation / Service

How did you discover EARTHWALK Sacred Journeys?

Do you have previous Travel Experience? If ‘yes’ please provide a list of countries visited…

Have you journeyed with Leanne at any time prior to now either on a Sacred Journey or through 1:1 Personal Programs?

Do you have an established morning practice? If so, what does this include?

Brief description of Personal Development Path to date.

Have you experienced working with any form of psychedelics? If ‘yes’ please provide details…

Do you have any addictions/distractions? If ‘yes’ please provide details …

Have you ever been diagnosed with any Mental Illness, ADHD, or similar? If ‘yes’ please provide details …

Are you taking any Prescription Medication or Self Prescribed Plant Medicines? If ‘yes’ please provide details …

What do you consider are your strengths?

What do you consider are your weaknesses?

What do you consider are your gifts?

Do you understand Sovereignty and accept full responsibility for the life that you are living today?

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