New Student Form – Entering the Stream

Welcome! Before beginning your one-to-one mentoring session or package, please fill out the form below. This can help you clarify your goals and intentions, and help us support you in your experience of inner practice. Many thanks!

*Please feel welcome to go at the pace that feels comfortable and safe to you. There’s no need to share anything you’d prefer not to, or would rather share in person later on. No pressure or stress at all.*

First, please read our Student Agreement here, and agree to the terms.

Agreement*
I have read and agree to the "Student Agreement."*
Name*
First Last
Email*
Your Location*
Have you practiced meditation, mindfulness, and/or other inner peace skills before? Please give the dates and length of any previous experience.
What do you intend or hope to get out of this session or program?
What current stressors are you facing?
Are there experiences you've had in the past that may still be causing you stress?
Again only to the extent that it feels right to you to share, do you have a history of trauma, and if so, are you actively experiencing symptoms that feel connected to that trauma? (Examples can include flashbacks, nightmares, strong emotions, or having difficulty with attention.)
Are you currently seeing a doctor, therapist, or counselor, and if so, do they know you'll be doing this mentoring work at Entering the Stream?
Are you currently taking medications for any physical or psychological conditions? If so, please feel free to share them below.
Are there any other health considerations that you'd like for us to be aware of (including any history of depression and/or self-harm)?
What internal and external resources do you have in your life that may offer you some support and bring you joy? :)
Please include an Emergency Contact, if you'd like to:
Relationship
Their email address
Their phone number
Is there anything else you'd like us to know at this time?

Thank you so much!

If you have any questions, please email support@enteringthestream.co.