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Client Insight Form
Gathering client information to create an impactful nourishing session.
Email address *
Full Name *
Your answer
Phone Number *
Your answer
What service are you applying for? Check more than 1 if applicable. *
Required
Your purpose for working with me? *
Your answer
Have you had energy work done before? *
Have you seen a psychic before? *
Have you had consultation call with me? *
If you had not had a call with me please list dates and times for availbility.
Your answer
Have you visited my website to view the holistic services? *
Do you agree to take responsibility for your own life and your own healing? *
Do you agree to listen with an open heart? *
Do you agree to decide for yourself what to do with the information provided? *
Do you agree that you are the only one responsible for any healing and growth? *
Do you give me permission to view your entire being; spiritually, emotionally, mentally and physically during our time together? *
What is your emotional block? *
Your answer
What do you feel like your challenge is? *
Your answer
What do you feel shame or guilt around? Please be honest and detailed.
Your answer
Do you have any physical ailments, had surgeries, pregnant, or any other issues? Please list and describe bodily sensations of all.
Your answer
How is the relationship with family? Please be honest and very detailed.
Your answer
What emotional and/or pyshcial traumas have you experienced that you can recall. Please be open , honest and detailed?
Your answer
What would you like to know about your life path?
Your answer
What would you like to know about the power of gratitude and law of attraction?
Your answer
What tools are you looking to receive from a session with me?
Your answer
What is the end result you are looking to receive from a session with me?
Your answer
Are you invested in working with me for multiple sessions? *
Please address other questions/concerns here.
Your answer
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