Let’s Co-Create Something Powerful. This short intake form helps us understand your goals, challenges, and how we might collaborate. Start with the basics. What’s your name? * First Name Last Name What’s your role or title? Email address * Phone number (###) ### #### Your pronouns Where are things feeling clear? Where are they feeling stuck? Lab Survey * I am clear on what’s not working in our organization or team. Strongly Disagree Disagree Neutral Agree Strongly Agree I feel confident in the systems and internal operations we currently have. Strongly Disagree Disagree Neutral Agree Strongly Agree I feel supported in managing our staff and/or community healing efforts. Strongly Disagree Disagree Neutral Agree Strongly Agree Our programs feel aligned with our mission and values. Strongly Disagree Disagree Neutral Agree Strongly Agree Our team is effectively navigating trauma-informed or healing-centered practices. Strongly Disagree Disagree Neutral Agree Strongly Agree Our team has a shared understanding of our biggest challenges right now. Strongly Disagree Disagree Neutral Agree Strongly Agree We’re open to rethinking how we do things, even if it means letting go of familiar systems. Strongly Disagree Disagree Neutral Agree Strongly Agree We have the capacity (time/energy) to make meaningful changes in the next 3 months. Strongly Disagree Disagree Neutral Agree Strongly Agree Our leadership communicates clearly and consistently across the team. Strongly Disagree Disagree Neutral Agree Strongly Agree There is psychological safety on our team (people can express concerns, needs, or feedback without fear). Strongly Disagree Disagree Neutral Agree Strongly Agree Burnout, grief, or emotional fatigue is impacting our work. Strongly Disagree Disagree Neutral Agree Strongly Agree We have clear, accessible documentation for our core programs, systems, or processes. Strongly Disagree Disagree Neutral Agree Strongly Agree We have the tools or platforms we need, but may not be using them to their full potential. Strongly Disagree Disagree Neutral Agree Strongly Agree What would success look like at the end of our work together? If you could wave a magic wand and fix one thing right now, what would it be? What are 1–2 things you’ve tried in the past to address these challenges? What kind of support are you looking for? What kind of support best describes what you're seeking right now? * Clarity on what’s not working A fresh perspective on internal systems or communication Help navigating a difficult or emotionally charged team dynamic Support designing or improving a healing-centered experience or event Creative help making our programs more trauma-informed I'm not totally sure—hoping you can help uncover that What’s your ideal timeline for starting this work? * Immediately (within 2 weeks) 2–4 weeks 1–2 months 2–3 months Flexible / not sure yet What’s your working budget range for this engagement? * Under $2,500 $2,500–$4,500 $4,500–$6,000 $6,000–$8,000 $8,000+ I don’t know—hoping to discuss options Thank you!
