Bead Here Now
Meditation Bead Questionnaire
Name:_______________________________ Date:
______________Contact Info:
Home Address: ____________________________ Tel. Num: (____)________________
_________________________ Email Address: ______________
Your answers to the following questions will assist me in determining what type of meditation beads will be most helpful for your use:
□ Use as sacred ritual (in conjunction with your particular spiritual practice)
□ Mantra (intentional saying) Repetition
□ Meditation aid – to help with focus
□ Decoration
□ Stress reliever
□ Other (please explain): _________________________________________________
□ General every day use
□ Addressing a particular issue, e.g., fear, anxiety, change, loss, grief, love
□ Sobriety or other recovery program
□ Gift for someone else
□ Other (please explain): _________________________________________________
3. Is there any particular form (representation) you identify with? (This might help not only with style, but also with the properties of the stones used)
□ The phases of the moon
□ The elements/environmental orientation
□ Eastern influence (Muslim, Buddist/Taoist, etc.)
□ Feminine focus (Goddess, Feminist, etc.)
□ Tarot/Runes/Astrology, etc.
□ Other (please explain): _________________________________________________
□ Rosary style
□ Unitarian Universalist (See description on website)
□ Favorite number or recurring number in your life that has significance ___________
□ Other (please explain): _________________________________________________
5. What healing properties do you think would be helpful to you? (Many gemstones are considered to have protective, talismanic, and medicinal properties and their therapeutic use dates back thousands of years. Gemstones are used in remedies for any number of ailments/states of the mind and body, helping with balance)
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6. Are there particular signs or symbols that you identify with or that repeat as a pattern in your life? (I will include the five universal signs of life (see description on website); the square, circle, triangle, equidistant cross and the spiral - unless you object, but one shape might appeal to you more than others and you might want to have more of it in the string)
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7. What size would you find most comfortable to use?
□ Pocketsize
□ Rosary size
In the Unitarian Universalist pattern - length is about - 12-20 inches stretched out before putting in a loop, depending on the size of the beads used.
8. Do you want additional "loops" to represent parts of you as an individual, either using items that you contribute (charms, medals, pieces of objects, etc.) or that I "find" for you? (I have used Mexican Milagros for example to represent health loops with certain parts of the body, or beads or buttons representing people or places, personal items - music notes, mustard seeds ... anything.
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9. Are you partial to certain colors - if they can be found with the qualities you want? (I would suggest this as last priority so as not to get caught up in how "pretty" they are - they are all beautiful in what they represent - but it is also good to know a preferred color)
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10. Are there particular materials you would like me to use in the creation of your meditation beads, e.g., glass, silver, fresh water pearls?) Please keep in mind that natural semi-precious stones, silver or gold, pearls etc. will add to the cost of your beads.
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11. What price range did you have in mind for your meditation beads?
□ $75-100
□ $150-200
□ $200+ - not limited by amount