INTAKE QUESTIONNAIRE — SPIRITUALISED

Designing a Space That Feels Safe for You.

This space honours your unique way of thinking, processing, and feeling. This quick form helps us understand how to support your full genius—whether you're neurodivergent, highly sensitive, or just wired a little differently.

Name

First Name

Last Name

1. Self-Identification

Do you identify as neurodivergent in any way? (ADHD, Autism, Dyslexia, etc.)

Are you formally diagnosed or self-identified?

2. Processing Preferences

Do you prefer video, written, or voice content?

Do you like to go deep or get summaries first and go back later?

Do you find it easier to focus in short sprints or long stretches?

3. Support Cues

When you’re overwhelmed, how does it show up for you?

What helps you regulate back to your power?

What does “being supported” feel like to you?

What do you wish more mentors understood about your inner world?

4. Environment + Learning Style

Are there sensory things that help you stay calm/grounded (music, scent, lighting)?

Do you prefer spontaneous, intuitive learning—or clear structures?

Anything you'd like to share about your learning environment or access needs?