Section 01
Your Story
Where it all begins.
In your own words, tell me your story.
This can be as long or short as you'd like. Where did you grow up? What was life like? What brought you to this moment?
What word or phrase would you use to describe your childhood?
Is there a moment from your past that still shapes who you are today?
Section 02
Family of Origin
The systems and dynamics that shaped you.
Describe your family growing up.
Who was in your household? What was the overall atmosphere — warm, tense, chaotic, quiet?
What was your relationship like with your mother?
Describe the closeness, distance, tensions, or love between you.
What was your relationship like with your father?
This includes absent fathers, stepfathers, or father figures as well.
What were your relationships like with your siblings?
If you have no siblings, describe what that experience was like for you.
How did your family handle conflict, emotions, or difficult conversations?
What messages — spoken or unspoken — did you receive about your worth, role, or identity?
Section 03
Relationships & Dynamics
How your past shows up in your present.
How would you describe your closest relationships today?
Friends, romantic relationships, family, community — what patterns do you notice?
Are there patterns in your relationships that keep repeating?
Who in your life has felt safe? What made them feel that way?
Is there a relationship that has caused you significant pain or loss?
Section 04
Faith & Spiritual Journey
Where God meets your story.
When did you give your life to God / get saved?
Share as much or as little of that story as you'd like.
What has your church experience been like?
Has it been life-giving, hurtful, complicated, or somewhere in between?
Are you actively serving in a church or other faith community right now?
If so, in what capacity?
How would you describe your relationship with God right now?
No answer is too honest — this is a safe space.
Has your faith been a source of strength, pain, or both in your story?
Section 05
Trauma & Mental Health
Giving language to what you've carried.
This section is entirely optional. You are only asked to share what you feel safe sharing. Nothing here will be used to label or define you — only to help me serve you better.
Have you ever experienced a traumatizing event?
This can include loss, abuse, accidents, violence, or any experience that left a deep mark on you. You do not have to share details — even a general yes or brief description is helpful.
Have you ever been diagnosed with a mental health condition?
Examples: depression, anxiety, PTSD, bipolar disorder, ADHD, etc.
Are you currently receiving any mental health support, therapy, or medication?
Is there anything in this area you'd like me to be aware of as we work together?