CFSD - The Art of Emotional Healing by Shelley Klammer

Welcome to Collage for Self-Discovery! In the interest of serving your needs better, I invite you to fill out a confidential survey about what you would most like to learn from the Collage for Self-Discovery Course.

Thank-you for taking 5-10 minutes to fill out this survey. I will keep your sharing confidential, and I will never share your private information with others.

I appreciate you taking the time to connect with me!

With care,

Shelley

INTAKE FORM

Name

Email

Age

Country

Date

WHO ARE YOU AS A CREATIVE PERSON?

1. Please share a bit about yourself as a creative person. Are you an artist, writer, therapist, teacher, art facilitator or student? Are you new to creative practices? What is your favourite creative practice at this time?

WHAT INSPIRED YOU TO JOIN THE COLLAGE FOR SELF-DISCOVERY COURSE?

2. What issue, struggle, problem, interest or curiosity led you to enroll in the Collage for Self-Discovery Course?

WHAT IS THE MAIN THEME OF YOUR INNER STRUGGLE?

3. If you were to explain your greatest challenge as a movie or book title what would it be called? I invite you to elaborate on what currently feels the most challenging in your life if it feels comfortable.

WHAT IS YOUR ONE WISH?

4. If you could have one wish fulfilled, what would it be, and how would it change your life?

WHAT ARE YOUR LEARNING PREFERENCES?

5. What would you most like to learn in the Collage for Self-Discovery Course?

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