AGODDESS LOVE · GLOBAL ASCENSION ACADEMY

The Wholeness Assessment™

A quiet, honest look at the woman you are right now — body, mind, soul, and spirit — before we begin our work together.

Take your time with this. There are no wrong answers, only honest ones. Wherever you are as you fill this in — that is exactly where we will begin.

YOUR NAME

YOUR EMAIL

Before We Begin

What brought you to seek this work at this specific point in your life?

What have you tried before — in coaching, therapy, healing, or self-work — and what happened?

If our work together were truly meaningful for you, what would you most want to understand, release, or become?

Medication & Substances

A few grounded, practical questions so I understand the full picture of what your body is working with.

Are you currently taking any prescription medications?

Yes No

PLEASE LIST EACH ONE AND WHAT IT IS PRESCRIBED FOR

Do you currently use alcohol, cannabis, cigarettes, vaping, or any other substances regularly?

Yes No

WHAT DO YOU USE, AND WHAT ROLE DOES IT PLAY — RELAXATION, SLEEP, COPING, HABIT, OR SOMETHING ELSE?

The Wholeness Map

As you score each section above, your map fills in below — a single picture of where you are right now, across every layer of you.

The Wholeness Reflection

Take a moment to look at your Wholeness Map and your answers. Instead of focusing only on the numbers, think about what you are learning about yourself.

Looking at your answers and scores, what stands out to you the most?

Do you notice one area of your life affecting another? If so, how?

What part of yourself — your needs, your body, your voice, your feelings, or your dreams — needs more of your attention right now?

What is the most important thing you want me to understand about you before we begin working together?

If I were completely honest with myself right now, I would admit that .

This is where our work in the Remembrance Method truly deepens — I'll meet you here.

What within me is asking to be remembered?

You don't have to resolve any of this right now. Just witnessing it is enough — I'll hold the rest when we meet.

Thank you, sister.

Your Wholeness Assessment has been received. What you've just shared took courage — I see it, and I honor it. I'll read every word before we sit together for your first session.

Keep an eye on your inbox — I'll be sending you a short meditation and affirmation practice to hold you gently until we meet.