PERSONAL SYMBOLS APPLICATION QUESTIONNAIRE PLEASE NOTE: your completing this questionnaire is optional. However, it is designed to help ensure suitability for you of the particular process offered here. What you say here helps me attune to participants’ general requirements. Therefore, completing this sheet will be much appreciated – and treated in absolute confidence. Please enclose with your booking form. Many thanks. Please summarise what it was it that attracted you to (delete as appropriate) this workshop?
To help maximise the rewards of this process for you, please consider what you may like to gain from attending:
As a basic VISUAL imagination is required, do you consider yourself able to imagine visually?
(please tick ü one) YES UNSURE NO
Please summarise your experience of quietly sitting/meditating/bringing your attention within yourself – stating whether you are comfortable with the prospect of engaging in this within the context of a small group:
Do you have any experience of participating in small groups?
(please tick ü one) YES – considerable YES – a little NO – none at all
Are you, at present, experiencing any psychiatric/psychological difficult and/or treatment? PLEASE NOTE: previous experience of difficulty/breakdown is regarded as part of your journey.
(please tick ü ) YES NO If ‘YES’ to any of the above, please summarise:
If you have any experience of (psychological) therapy, is this current? PLEASE NOTE: previous/current experience of therapy is likely to prove beneficial here
(please tick ü ) YES NO
Have you any specific practical requirements?
Is there anything else you wish to say regarding your participation in this workshop?