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Check-in Form

Please make time to fill this out by the end of the week. Every word is strictly confidential.

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Question 1 of 6

What is one takeaway I had from my last session with Jenna? Did I feel a shift?

Question 2 of 6

What am I grateful for, and/or what do I want to acknowledge/celebrate myself for this week?

Question 3 of 6

What is going on in my mind and my home right now? What am I facing?

Question 4 of 6

What, if anything, would make my sessions better? What do I need that I'm not yet getting in this program?

Question 5 of 6

Is there anything I would like to express or share right now as I wrap up this check-in?

Question 6 of 6

 (This isn't a question) It is such an honor to have you here. This work is not always easy, and it is rewarding. I want to recognize you for that. 

 

We will send you a prep form prior to your next session as well. Please fill it out so I have both this form and that one to align our next steps together. 

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