Confidential Assessment and Application

This brief intake helps determine whether the Chrystalis container is the appropriate level of support for what you’re navigating now. All responses are held in confidence. Completion time: approximately 4–6 minutes.

First Name *

Email *

How did you learn about Stephanie? *

What prompted you to inquire at this point in your life? *

A transition or inflection point

A desire for greater coherence and clarity

Health or nervous system recalibration

Relational or family dynamics

Vocational or leadership realignment

An intuitive nudge I trust

Which areas feel most relevant to your inquiry? (check all that apply) *

Health & vitality

Emotional or nervous system regulation

Relationships or intimacy

Leadership, vocation, or creative direction

Spiritual embodiment or integration

Identity refinement or life architecture

Why is now the right moment to explore support? *

How would you describe your relationship to inner work or personal development? *

Long-term, consistent practitioner

Periodic but serious engagement

Intuitively guided, non-linear path

Newer, but deeply committed

When working with a guide or mentor, what do you value most? (check all that apply) *

How do you typically make important decisions? *

I know quickly when something is aligned

I reflect briefly, then decide

I consult my intuition and timing

I take time and gather perspective

Which style of support are you most drawn to right now? *

Highly personalized, private immersion

Hybrid (private with light group or app support)

Self-directed with occasional guidance

Unsure — seeking discernment

How much space do you realistically have to integrate support over the next 3–6 months? *

I can prioritize this fully

I have capacity with thoughtful pacing

I’m navigating complexity but making room

I’m exploring timing

For a discreet, high-touch container, I am comfortable investing: *

$5,000 – $10,000

$10,000 – $25,000

$25,000+

I’d like to explore lighter pathways first

What are you most hoping will be different after this season of support? *

What tends to challenge you when entering a deeper container of growth? *

Is there anything important you’d like me to know before we speak? *

If invited, when would you ideally begin? *

Immediately

Within 30 days

Within 60–90 days

Timing is flexible

What best describes your current status? *

Actively seeking private support

Exploring alignment and fit

Referred and curious

Following intuition, open to guidance

Full Name

Phone *

Confidentiality acknowledgment *

I understand this is a selective process and that not all inquiries result in an invitation to work together.