Body Session — Intake

Your body blueprint begins here.

This form helps your practitioner understand where you are today and where you want to go. There are no right or wrong answers — the more honest and detailed you are, the more precise your protocol will be. Your information is held in strict confidence.

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Step 1 of 7 — Personal Information
01 — Personal Information

Tell us about yourself.

Basic information to establish your client profile.

Optional but recommended
02 — Health Foundation

Your health today.

An honest picture of where your body is right now — the foundation we build your protocol from.

Very lowOptimal
Very poorExcellent
03 — Current Medications

Medications you are taking.

Please list all prescription and over-the-counter medications. This is essential for building a safe and effective protocol and is held in strict confidence.

04 — Supplements & Nutrition

What you put in your body.

Your current supplement stack and dietary habits give us a starting point for building your optimised nutrition protocol.

Include vitamins, minerals, adaptogens, herbs, or any other supplements you currently take
05 — Movement & Exercise

Your body in motion.

Your current and historical relationship with movement — this shapes your exercise protocol entirely.

06 — Wellness & Longevity Goals

Where you want to go.

Your goals drive every decision in your protocol. Be as specific and ambitious as you like — we build backwards from where you want to be.

ExploringFully committed
07 — Acknowledgment

Before we begin.

Please read and acknowledge the following before submitting your intake.

Not a substitute for medical care

Divine Blueprint wellness protocols are designed to support and optimise your health — they are not a substitute for medical diagnosis, treatment, or advice from a licensed physician. If you have a serious health condition, please continue to work with your medical team alongside this program.

Confidentiality & data use

All information you submit is held in strict confidence. Your intake is accessible only to your assigned practitioner and is used solely for the purpose of building and refining your personal wellness protocol. It will never be shared, sold, or used for marketing purposes.

Mind Session — Intake

Your mind blueprint begins here.

This intake supports your iPEC-based coaching work. It helps your coach understand the patterns, beliefs, and goals you are bringing into the room — so your first session starts deep, not from zero. There are no right or wrong answers.

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Step 1 of 5 — Personal Information
01 — Personal Information

Tell us about yourself.

Basic information to establish your client profile.

02 — Where You Are Now

Your life as it stands today.

A snapshot of how satisfied and energised you feel across the areas of your life.

StrugglingThriving
DepletedFully charged
03 — Patterns & Beliefs

What repeats, and what holds.

iPEC coaching works with the beliefs and energetic patterns underneath your behaviour. Your honest reflection here gives your coach a head start.

Coaching complements therapy but does not replace it
04 — Goals & Vision

Where you want to go.

Coaching is built backwards from your vision. The clearer you can be, the more precisely we can work.

ExploringFully committed
05 — Acknowledgment

Before we begin.

Please read and acknowledge the following before submitting your intake.

Coaching is not therapy

iPEC coaching is a forward-focused partnership for growth and change. It is not psychotherapy, counselling, or treatment for mental health conditions, and it does not replace care from a licensed mental health professional. If at any point therapeutic support would serve you better, your coach will say so openly.

Confidentiality

Everything you share in coaching is held in strict confidence by your coach, with the standard exceptions required by law. Your intake is visible only to your assigned coach.

Soul Session — Life Activation Intake

Your soul blueprint begins here.

The Life Activation is a 2-hour, in-person session from the Modern Mystery School lineage. This intake helps your practitioner prepare the session around where you are — your spiritual background, your intentions, and anything they should hold with care.

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Step 1 of 5 — Personal Information
01 — Personal Information

Tell us about yourself.

Basic information to establish your client profile.

02 — Spiritual Background

Your path so far.

There is no required background for a Life Activation — this simply helps your practitioner meet you where you are.

03 — Where You Are Now

What is moving in your life.

Life Activations often arrive at thresholds — transitions, awakenings, or moments of searching. Tell us about yours.

DisconnectedDeeply connected
In upheavalVery settled
Optional — share only what feels right
04 — Intentions & Preparation

What you wish to awaken.

The Life Activation works with your intention. You will also spend 2 hours in person with your practitioner — a few practical notes help us prepare the space for you.

Optional
Optional — helps us prepare the space
05 — Acknowledgment

Before we begin.

Please read and acknowledge the following before submitting your intake.

A spiritual practice, not medical care

The Life Activation is a spiritual and energetic practice from the Modern Mystery School lineage. It is not medical treatment, mental health care, or a substitute for either. Please continue any care you are receiving from licensed professionals.

Confidentiality

Everything you share is held in strict confidence by your practitioner. Your intake is visible only to your assigned practitioner and is used solely to prepare and support your session.

Welcome back

Sarah's Blueprint

Next session: Body Session with Dr. Reeves — July 14, 2026 · 10:00 AM

Current membership
Gold
Renews August 1, 2026 · $249/mo
Upcoming

Body Session — July 14

Your monthly Gold consultation with Dr. Reeves. Agenda: Q2 lab review, supplement protocol update, and exercise progression check-in.

Your Active Protocol

Full protocol

Nutrition Protocol

Mediterranean base with strategic carb cycling. Protein target 160g/day. 16:8 intermittent fasting window on non-training days.

Updated June 2026Phase 2

Supplement Stack

Morning: Vitamin D3 5000IU + K2, Magnesium glycinate 400mg, Omega-3 2g, CoQ10 200mg. Evening: Ashwagandha 600mg, NMN 500mg.

Updated June 20266 supplements

Exercise Protocol

4x strength training per week (upper/lower split). 2x Zone 2 cardio 45 min. Sunday: mobility & recovery. Weekly sauna 3×20 min.

Updated May 2026Phase 3

Progress Metrics

View all
Energy level
8.2 /10
↑ +1.8 since intake
Sleep quality
7.6 /10
↑ +2.1 since intake
Body weight
162 lbs
↓ −8 lbs since intake
Stress level
4.1 /10
↓ −2.3 since intake

Session History

All sessions
Jul
14
Body Session — Monthly Gold Consultation
Dr. Reeves · Phone · 45 min
Upcoming
Jun
12
Body Session — Lab Review & Protocol Update
Dr. Reeves · Phone · 45 min
Completed
May
8
Body Session — 90-day Check-in
Dr. Reeves · In-person · 60 min
Completed
Mar
3
Body Session — Initial Consultation
Dr. Reeves · In-person · 90 min
Completed

Secure Messages

All messages
Dr. Reeves
Your Q2 labs came in — overall excellent. Vitamin D is now optimal at 68 ng/mL. Let's discuss the one flag on our call July 14.
Jul 1, 2026 · 2:14 PM
You
Thanks — should I adjust anything before the call? Also noticed better sleep this week on the magnesium timing change.
Jul 1, 2026 · 4:30 PM
Dr. Reeves
Good to hear on the sleep — keep the timing as is. No changes needed before the call. See you on the 14th.
Jul 2, 2026 · 9:05 AM

My Documents

All files
Body Blueprint Protocol — Phase 2
PDF · Updated June 12, 2026
→
Q2 Lab Results — June 2026
PDF · Uploaded July 1, 2026
→
Supplement Schedule — Current
PDF · Updated June 12, 2026
→
Initial Intake Form — March 2026
PDF · Submitted March 3, 2026
→

Membership

Manage
Gold Plan
$249/mo
Monthly 45-minute consultation
Protocol updates & lab review
Priority practitioner messaging
Billing & Payments

Your account, in order.

Membership, payment methods, and every transaction — all in one place.

Next charge
$249.00
Gold membership · August 1, 2026
Active payment plan

The Protocol — 3-month plan

Instalment 2 of 3 · $840.00 charged June 15 · Final instalment $840.00 due July 15, 2026

Transaction History

Download all
Gold Membership — July 2026
Jul 1, 2026 · Visa •••• 4421 · Recurring
$249.00
Invoice
The Protocol — Instalment 2 of 3
Jun 15, 2026 · Visa •••• 4421 · Payment plan
$840.00
Invoice
The Merkaba Pendant — Atelier order #1042
Jun 12, 2026 · Apple Pay · Shipped
$210.00
Invoice
Gold Membership — June 2026
Jun 1, 2026 · Visa •••• 4421 · Recurring
$249.00
Invoice
Soul Session — Life Activation
May 22, 2026 · Visa •••• 4421 · In-person session
$255.00
Invoice
The Protocol — Instalment 1 of 3
May 15, 2026 · Visa •••• 4421 · Payment plan
$840.00
Invoice
Mind Session — iPEC Coaching
May 8, 2026 · Visa •••• 4421 · 1-hour session
$297.00
Invoice

Membership

Change plan
Gold Plan
Active
$249/mo
Member sinceMarch 2026
Next renewalAugust 1, 2026
Billing cycleMonthly

Payment Methods

Add new
VISA
Visa ending 4421
Expires 09/28 · Default
Default
Apple Pay
Connected

Billing Details

Edit
NameSarah Mitchell
Emailsarah@example.com
Billing address128 Greene St
New York, NY 10012

Practitioner-Directed Care

Some advanced protocol elements prescribed by your practitioner are fulfilled and billed directly through our licensed pharmacy partner. Those charges will appear on their statements, not here.

Questions? Message your practitioner