SANCTUARY SATURDAY SESSIONS

Personal Snapshot

First name

Last name

Email

Birthday

Month

Day

Year

Time Zone

Primary Occupation / Lifestyle Context (e.g., desk-based, shift work, athlete, caregiver):

Your Why (Clarity & Intention)

What prompted you to seek Biotuning now? (1–2 sentences)

In one word, how would you describe how your body currently feels most days?

In one word, how would you like your body to feel six months from now?

Current State of Your Biology

Rate the following over the last 30 days (0 = very poor, 5 = excellent) and indicate your sense of personal agency/control:

Stress & Recovery Signals

Check all that apply:

I wake up feeling unrested

I feel wired but tired

I experience frequent tension, anxiety, or irritability

I struggle to slow down or relax

I feel emotionally numb or disconnected

I recover slowly from workouts, travel, or stress

None of the above

Biotuning Stressor Familiarity

Nervous System Signal: Breath Retention / CO₂ Sensitivity Test

This is a non-diagnostic self-awareness check to understand stress tolerance and nervous system sensitivity.

Instructions:

Exhale normally through the nose.

Gently exhale all remaining air.

Hold your breath until the first clear urge to breathe.

Time (seconds):

Choose one

Less than 15 sec (high sensitivity / anxiety-prone state)

15–25 sec (moderate sensitivity)

25–40 sec (balanced tolerance)

40+ sec (high tolerance)

During the hold, what did you notice?

Calm

Rising anxiety or panic

Strong physical tension

Mental urgency or fear-based thoughts

Takeaway:

“My anxiety, panic, or mental urgency may be a biological tolerance issue—not a personal flaw.”

Self-Medication Strategies

Health Context (Brief)

Is there anything else your Biotuning coach should know? (optional)

Daily Capacity

On a typical day, how much time can you realistically dedicate to Biotuning practices?

5–10 minutes

10–20 minutes

20–40 minutes

Varies day to day

Self-Assessment: Listening to Your Body

Complete the sentence: If my body could speak clearly right now, it would be asking me to:

Commitment & Consent

Biotuning works through consistency, curiosity, and cultivating emotional intelligence.

I am willing to engage in small, intentional stressors

I understand this is not medical treatment or diagnosis

I am open to relearning how my body communicates

I can swim and tread water

Your body already knows the way home. This intake helps us listen.

Total Cost

$200

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