FAMILY CONSULTATION
Family Consultation Form
Heal your Trans-Generation Trauma
Mark the defining events of your family across three generations. This map creates the ground for seeing transgenerational patterns, and its data is saved for your consultation session.
To securely save your form to an account and send it directly to your consultant, sign in or create an account.
Sign in / Sign up| No | Condition | Client | Mother | Maternal grandmother | Maternal grandfather | Maternal ancestors | Father | Paternal grandmother | Paternal grandfather | Paternal ancestors | Brother | Sister | Spouse |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Miscarriage | ||||||||||||
| 2 | Loss of a child after birth | ||||||||||||
| 3 | Early death before age 30 | ||||||||||||
| 4 | Death from an incurable illness such as cancer | ||||||||||||
| 5 | Pandemic | ||||||||||||
| 6 | Divorce | ||||||||||||
| 7 | Remarriage | ||||||||||||
| 8 | War | ||||||||||||
| 9 | Migration | ||||||||||||
| 10 | Captivity | ||||||||||||
| 11 | Imprisonment | ||||||||||||
| 12 | Exile | ||||||||||||
| 13 | Murder | ||||||||||||
| 14 | Being killed | ||||||||||||
| 15 | Accident | ||||||||||||
| 16 | Financial bankruptcy | ||||||||||||
| 17 | Adoption | ||||||||||||
| 18 | Rejected by the father | ||||||||||||
| 19 | Rejected by the mother |
Tap a cell to mark or unmark it — changes are saved automatically.
0 marked events
For now, the form data is saved only on this device. To save it securely to the cloud and send it directly to your consultant, sign in to your account.