Sacred Initiation Intake Form

☥ 5-Day Sacred Initiation Intake Form ☥

A Private 1:1 Retreat & Mentorship with Deanna ૐ Dhyana

Enter the temple of transformation. This is your invitation into soul liberation, womb healing, and divine feminine embodiment.

All answers are confidential and held in sacred respect.

Before You Begin:

This is a sacred experience. Please take a few moments to drop in, breathe, and tune into your heart before completing this application. I honor your truth and am here to hold space for your highest expansion. Answer the following questions with honesty, devotion, and presence. Each reflection is a key to your sacred healing.

Full Name

How did you hear about this 5 Day Sacred Initiation?

What inspired you to say yes to this Sacred Initiation?

(Please share from the heart. No need to be perfect—just present.)

What core patterns or wounds have you been navigating (ancestral, emotional, relational, spiritual, etc.)?

(Be as open as you feel called to be—this helps guide the container we will co-create.)

How do you desire to feel by the end of this experience?

(Clarity, reclamation, support, womb healing, divine purpose, empowerment, embodiment, soul-gift activation, etc.)

What fears or resistances are coming up as you enter this journey?

(Honesty is sacred here. You’re safe to name anything that may be surfacing.)

Do you have any energetic, emotional, or physical sensitivities we should be aware of?

(Optional — this helps us honor your body and boundaries in the most loving way.)

Have you ever worked with sacred mentorship, energy alchemy, or embodiment practices before?

Yes

A little, but I'm new to this depth

Other

☥ Day 1: Womb Crystal Clearing & Energy Alchemy ☥

What emotions or patterns have been surfacing in your womb or lower belly?

(Tune into your body — what have you been feeling in your sacred center?)

Do you feel any stagnation or heaviness in your creative or sexual energy?

(Share openly if anything feels blocked, numb, or unclear.)

Are there any ancestral wounds or mother/father/childhood themes you feel ready to release?

(This is a space for emotional truth and sacred release.)

☥ Day 2: Root & Sacral Chakra Emotional Alchemy ☥

In what ways have you felt disconnected from safety, sensuality, or trust in your mind or body?

(Let your body speak — what has felt ungrounded or unheld?)

Are there emotional wounds, toxic relationships, or fears rooted in early life or generational trauma?

(This may include past heartbreak, family patterns, or early conditioning.)

What are you ready to reclaim or feel more empowered in?

(Speak to the part of you that is ready to rise and be seen.)

What are you ready to give birth to in order to receive your next level of awakening?

( Imagine what you are ready to create, receive, or step into.)

☥ Day 3: Solar Plexus & Heart Soul Expansion ☥

What areas of your life are calling for more courage or confidence?

( Share where you are being called to rise in your personal power.)

Are there old stories or beliefs limiting your personal power or ability to give/receive love?

( Gently name the beliefs that no longer serve your truth.)

How does your heart want to lead your sacred path forward?

( Tune into your heart wisdom and describe what it wants to guide.)

In what ways have you held fear in giving or receiving love?

( Explore where love may have felt unsafe, unbalanced, or withheld.)

☥ Day 4: Voice & Vision Activation ☥

In what ways have you silenced your voice or withheld your truth?

( Where have you played small or held back your authentic expression?)

What are you ready to proclaim in your life moving forward?

( Declare what truth, message, or mission you are ready to speak boldly.)

What visions or intuitive insights have you been receiving recently?

( Share your dreams, downloads, or nudges from the divine.)

What are your greatest visions or intentions you desire to see manifest in your life?

(Feel into your future — what is calling you forward?)

☥ Day 5: Lotus Crown Rebirth & Soul Purpose Activation ☥

What do you feel your soul is here to remember, reclaim, or rebirth?

(Speak from your soul’s memory — what feels ancient, sacred, or true?)

What gifts do you feel deep within are ready to burst forth?

(These could be talents, messages, or healing abilities you feel emerging.)

What dreams or sacred visions are beginning to emerge?

(What future self or mission is beginning to reveal itself to you?)

How would it feel to fully embody your divine purpose and sacred gifts with complete clarity, wisdom, confidence, and flow?

(Describe the energy, embodiment, and power of your fully awakened self.)

☥ Day 5: Lotus Crown Rebirth & Soul Purpose Activation ☥

If this 5-Day Sacred Initiation opens a deeper portal of healing and embodiment for you, would you be open to exploring how we can continue this sacred work together in a longer immersion or program?

Yes, I feel a sacred YES and I’m open to receiving more.

I’m curious and would love to feel into what’s possible.

I’m not sure yet, but I’m open to seeing how the sessions resonate.

Not at this time, but thank you with all my heart.

(Choose what feels most aligned for your soul at this time—there’s no obligation, only invitation.)

If you felt divinely aligned to deepen this sacred work beyond the 5-Day Initiation, what type of energetic exchange feels most accessible to you at this time for continued mentorship or immersion?

$44.44-$111.11 per month

$111.11-$333.33 per month

Under $1,111

$1,111–$3,333

$3,333–$5,555

$5,555 and beyond—I’m ready to fully invest in my Sacred Embodiment and Next Level Goddess Energy

Not at this moment, but I’m open to calling in the resources and receiving divine support if this path is meant for me.

Other

(This helps me tune into where you're at and how I can best serve you.)

Is there anything else your soul wants me to know before we connect?

✦ Submit & Receive ✦

Thank you, Beloved, for your sacred sharing.

Your words, energy, and intentions have been received in divine trust and reverence. You’ve taken a powerful step toward deep transformation and remembrance.

Your journey through this portal of healing, embodiment, and soul activation is already unfolding—and your responses will help us tune in to exactly what your soul is ready to receive.

Take a deep breath, soften into your heart, and know:

You are held. You are seen. You are ready.☥

With Love, Devotion & Flow,

Deanna ૐ Dhyana - ☥Priestess |𓂀Alchemist |☬Tantrika | ૐSacred Flow Shaman | Author & Creatrix of The Goddess Flow Method™ 𓂀 CEO of Goddess Flow International

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