Your Art to Heart Consultation

Dear Creative Spirit,

Thank you for booking an Art to Heart Consultation. To serve you to the best of my abilities, I will need you to complete the following form before our appointment.

You may save the form and continue later at any time. Simply scroll to the bottom of this page and click the “Save and continue” button. You will then be asked to provide an email address so my website elves can send you a link to the saved form!

If you have any problems or concerns, don’t hesitate to email me at support@danadaponte.com or call me at (403) 554 9884.

With love,
Dana da Ponte

Name*
First Last
Email*
What type of spiritual practices do you currently enjoy?
What kind of art activities do you enjoy?
Do you currently use essential oils?
- Yes!
- No.
Where do you currently purchase them?
Which oils, and how do you like to use them?
Body Scan Exercise
Where is your body feeling tense, sore, loose, relaxed, stressed, nauseous, hurt, tight etc. and why do I think it is feeling that way?
Please note: You may like to first brainstorm your body scan notes on paper. Download and print this PDF so that you can draw or write how your body feels all over the body image!
Where is your body feeling tense, sore, loose, relaxed, stressed, nauseous, hurt, tight etc. and why do I think it is feeling that way?
Body Part How does that body part feel? What do you think caused your body to feel that way?

{Click the + button to add more rows}
Hidden
Spiritual, Emotional and Physical Priorities
List your 3 most important priorities in each category.
Hidden
Spiritual Priorities
Spiritual Priorities may include things like wanting to connect to Spirit, wanting to learn how to develop your intuition, learning how to follow and trust your own path, learning how to tap into your creativity, learning to set intentions, healing the mother wound, standing in your power, forgiving yourself and others, practising mindfulness, receiving message from your Spirit Guides or Angels, live a deeper and more meaningful life.
Hidden
Emotional Priorities
Emotional Priorities may include things like experiencing more harmony in relationships, feeling more connected to the people you love, managing grief and loss, overcoming anger, living with more passion, learning to feel your feelings, learning to live with emotional sensitivity, managing anxiety, learning how to meet your unmet emotional needs, learning to mother yourself, developing better self-care rituals, parenting issues
Hidden
Physical Priorities
Physical Priorities may include things like health concerns, career issues, desired changes for your home, body care, body love, sex, sleeping, non-toxic house cleaning options, immune system, skin care needs, family health
Physical Priorities:
Physical Priorities may include things like health concerns, career issues, desired changes for your home, body care, body love, sex, sleeping, non-toxic house cleaning options, immune system, skin care needs, family health
The issues I’m most concerned about in my physical body or environment are:
Describe Physical Concern here: Describe how it affects you here:

{Click the + button to add more rows}
Emotional Priorities:
Emotional Priorities may include things like experiencing more harmony in relationships, feeling more connected to the people you love, managing grief and loss, overcoming anger, living with more passion, learning to feel your feelings, learning to live with emotional sensitivity, managing anxiety, learning how to meet your unmet emotional needs, learning to mother yourself, developing better self-care rituals, parenting issues
The issues I’m most concerned about for my relationships and/or emotional well-being are:
Describe Emotional Concern here: Describe how it affects you here:

{Click the + button to add more rows}
Spiritual Priorities
Spiritual Priorities may include things like wanting to connect to Spirit, wanting to learn how to develop your intuition, learning how to follow and trust your own path, learning how to tap into your creativity, learning to set intentions, healing the mother wound, standing in your power, forgiving yourself and others, practising mindfulness, receiving message from your Spirit Guides or Angels, live a deeper and more meaningful life.
The issues I’m most concerned about for my spiritual well-being are:
Describe Spiritual Concern here: Describe how it affects you here:

{Click the + button to add more rows}
Choose Three Main Priorities to Focus on
The three most important priorities to me right now are:
Physical:
Emotional:
Spiritual:
Comments
This field is for validation purposes and should be left unchanged.

Save and Continue Later

Body Part	How does that body part feel?	What do you think caused your body to feel that way?

Describe Physical Concern here:	Describe how it affects you here:

Describe Emotional Concern here:	Describe how it affects you here:

Describe Spiritual Concern here:	Describe how it affects you here:

Your Art to Heart Consultation

Body Scan Exercise

Spiritual, Emotional and Physical Priorities

Physical Priorities:

Emotional Priorities:

Spiritual Priorities

Choose Three Main Priorities to Focus on

Subscribe to receive hand-drawn journal pages to enjoy every full and new moon: