NVŌK — Invitation Questionnaire

Private • Capacity-Reserved • By Invitation

This questionnaire is reviewed privately and is used to confirm fit, readiness, and the level of container required.

Please share only what you feel comfortable sharing.

NVŌK is not an emergency service. If you are in crisis or immediate danger, contact 911 or local emergency services.

Section A — Private Identity & Logistics

1. Full legal name

2. Preferred name

3. Email

4. Phone

5. Address

Country/Region

Address

City

Zip / Postal code

6. Birthday

Month

Day

Year

7. Do you want communications routed through an assistant/family office?

Yes

No

If yes, please provide contact information.

8. Who invited you and what is their relationship to you?

Section B — The Real Reason (confidential)

9. What is the quiet truth you rarely say out loud?

10. What have you “solved” externally that still isn’t solved internally?

11. What feels missing—even inside a beautiful life?

Section C — The Pattern Beneath the Surface

12. If you had to name the pattern, what is it? (Examples: over-functioning, self-monitoring, emotional containment, hyper-independence, inability to receive, numbness, loneliness in company.)

13. When does it show up most? (Choose up to two)

14. What does your nervous system default to?

Section D — Desired Outcome (precision)

15. What would “coming home to yourself” look like—specifically?

16. What are the non-negotiables for how this must feel?

Section E — Prior Work & Fit

17. Have you done therapy/coaching/somatic work/hypnosis before?

Yes, currently

Yes, in the past

No

18. What helped? What did not?

19. What are you unwilling to do again?

20. Are you willing to engage with subconscious/emotional pattern work without “performing wellness”?

Yes

No

Section F — Health & Safety

21. Do you currently have chronic pain and/or chronic fatigue?

Yes

No

22. Do you have any autoimmune disorders?

Yes

No

23. If yes to either, share only what feels relevant (optional)

Have you ever experienced any of the following? *

Seizures / epilepsy?

Psychosis / hallucinations?

Unmanaged bipolar / mania?

Severe dissociation?

Active substance dependence?

None of the above.

25. Are you currently under the care of a physician or mental health professional?

Yes

No

26. Are you currently experiencing thoughts of self-harm?

Yes

No

If yes, NVOK is not crisis support. Please contact 911.

Section G — Discretion & Container

27. Which level of privacy do you require?

Standard private (direct communication with me)

High discretion (assistant coordinates logistics)

Highest discretion (authorized payer/family office handles all billing + scheduling)

28. Do you require discreet invoicing language?

Yes

No

Section H — Logistics (immersion cadence)

29. Preferred engagement format

In person (Naples)

Virtual (secure)

Travel based (outside Naples)

Hybrid

30. Weekly cadence expectation

Weekly immersion is ideal

Every other week is ideal

I need flexibility week to week

31. Best windows for scheduling?

Weekday mornings

Weekday afternoons

Evenings

Weekends

Section I — Investment Readiness

32. NVŌK is a capacity-reserved private engagement. If aligned, are you prepared to move forward promptly?

Yes

No

33. Who approves investment?

I do

Authorized payer / family office

Assistant coordinates

Other

34. Preferred payment method

ACH / wire

Credit card (by request)

Not sure yet

Section J — Consent & Acknowledgements

I understand NVŌK is not emergency or crisis support.

I understand NVŌK does not provide medical diagnosis or medical treatment.

I understand results vary and no outcomes are guaranteed.

I confirm what I shared is accurate to the best of my knowledge.

Anything you want me to know before we speak—without filtering it?

Signature

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Date

Month

Day

Year